Rautamo Maria, Kvarnström Kirsi, Sivén Mia, Airaksinen Marja, Lahdenne Pekka, Sandler Niklas
HUS Pharmacy, HUS Helsinki University Hospital, Stenbäckinkatu 9B, 00290 Helsinki, Finland.
Faculty of Pharmacy, University of Helsinki, Viikinkaari 5E, University of Helsinki, 00014 Helsinki, Finland.
Pharmaceutics. 2020 Jan 30;12(2):109. doi: 10.3390/pharmaceutics12020109.
Oral drug administration to pediatric patients is characterized by a lack of age-appropriate drug products and the off-label use of medicines. However, drug administration practices at hospital wards is a scarcely studied subject. The aim of this study was to explore the oral drug administration practices at pediatric hospital wards, with a focus on experiences and challenges faced, methods used to mitigate existing problems, drug manipulation habits, perceptions about oral dosage forms and future needs of oral dosage forms for children. This was a qualitative study consisting of focus group discussions with physicians, nurses and clinical pharmacists in a tertiary university hospital with the objective of bringing forward a holistic view on this research topic. These healthcare professionals recognized different administration challenges that were classified as either dosage form-related or patient-related ones. A lack of depot formulations developed especially for children as well as oral pediatric dosage forms of drug substances currently available as intravenous dosage forms was recognized. The preferred oral dosage forms were oral liquids and orodispersible tablets. Patient-centered drug administration practices including factors facilitating drug administration both at hospital wards and at home after patient discharge were identified. Among all healthcare professionals, the efficient cooperation in drug prescribing and administration as well as in educating the child's caregivers in correct administration techniques before discharge and improving the overall discharge process of patients was emphasized. This study complements the prevalent understanding that new dosage forms for children of varying ages and stages of development are still needed. It also brings a holistic view on different aspects of oral drug administration to pediatric patients and overall patient-centered drug administration practices.
儿科患者口服给药的特点是缺乏适合其年龄的药品以及药品的超说明书使用。然而，医院病房的给药实践是一个鲜有研究的课题。本研究的目的是探讨儿科医院病房的口服给药实践，重点关注所面临的经验和挑战、用于缓解现有问题的方法、药物调配习惯、对口服剂型的看法以及儿童口服剂型的未来需求。这是一项定性研究，包括在一家三级大学医院与医生、护士和临床药剂师进行焦点小组讨论，目的是对这一研究课题提出全面的看法。这些医疗保健专业人员认识到不同的给药挑战，这些挑战被归类为与剂型相关或与患者相关的挑战。人们认识到缺乏专门为儿童开发的长效制剂，以及目前作为静脉剂型提供的药物的口服儿科剂型。首选的口服剂型是口服液体制剂和口腔崩解片。确定了以患者为中心的给药实践，包括在医院病房和患者出院后在家中促进给药的因素。在所有医疗保健专业人员中，强调了在药物处方和给药以及在出院前对儿童护理人员进行正确给药技术教育和改善患者整体出院过程方面的有效合作。本研究补充了普遍的认识，即仍需要针对不同年龄和发育阶段儿童的新剂型。它还对儿科患者口服给药的不同方面以及以患者为中心的整体给药实践提出了全面的看法。
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