Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
Central Norway Hospital Pharmacy Trust, Trondheim, Norway.
Fam Pract. 2019 May 23;36(3):351-356. doi: 10.1093/fampra/cmy086.
Finding appropriate medicinal product formulations and dosage forms for children can be challenging. Knowledge about considerations behind which medicinal product to prescribe or dispense for children is lacking.
To explore considerations of formulation characteristics of medicinal products made by GPs when prescribing and by pharmacists when dispensing medicines for children 0-6 years of age.
A qualitative study was performed by conducting three semi-structured focus groups with GPs and three with pharmacists, using nearly identical thematic interview guides. Analysis was performed using systematic text condensation.
Both GPs and pharmacists considered whether children and parents were willing and able to use medicinal products such as tablets and poor-tasting liquids before prescribing and dispensing them. These considerations were commonly based on health care workers' prior experiences, although parents and sometimes children were asked about their experiences with solid formulations. For antibiotics, GPs primarily wanted to prescribe first-choice antibiotics according to guidelines. Parents' concerns about getting the child to take the medicinal product due to poor taste could lead to the prescription of second-choice antibiotics. The pharmacists sometimes changed the prescribed formulation at parents' request but never changed the type of antibiotic without contacting the prescriber.
Formulation characteristics strongly influenced which medicinal product children were prescribed and dispensed. Individualizing formulation choices for children through an increased collaboration between physicians, pharmacists and parents is suggested.
为儿童寻找合适的药物制剂和剂型可能具有挑战性。缺乏关于为儿童开具或配药时应考虑哪些药物的知识。
探讨全科医生在为儿童(0-6 岁)开具处方和药剂师在配药时对药物制剂特性的考虑因素。
通过对全科医生进行 3 次半结构式焦点小组讨论和对药剂师进行 3 次半结构式焦点小组讨论,使用几乎相同的主题式访谈指南进行了一项定性研究。使用系统文本冷凝法进行分析。
全科医生和药剂师在为儿童开具和配药之前,都考虑了儿童及其父母是否愿意和能够使用片剂和味道不佳的液体等药物。这些考虑通常基于卫生保健工作者的既往经验,尽管有时会询问父母和儿童他们对固体制剂的使用经验。对于抗生素,全科医生主要根据指南开具首选抗生素。由于味道不佳,父母担心孩子服药,这可能导致开具二线抗生素。药剂师有时会应父母的要求改变处方制剂,但从未在未联系处方医生的情况下改变抗生素类型。
制剂特性强烈影响了儿童开出和配给的药物。建议通过增加医生、药剂师和家长之间的合作,为儿童个性化选择制剂。