Vallet Thibault, Michelon Hugues, Orlu Mine, Jani Yogini, Leglise Patrick, Laribe-Caget Sandra, Piccoli Matthieu, Le Fur Aurélie, Liu Fang, Ruiz Fabrice, Boudy Vincent
ClinSearch, 110 Avenue Pierre Brossolette, 92240 Malakoff, France.
Pharmacy department, Hôpital Sainte-Périne, Groupe Hospitalier Universitaire AP-HP.Paris-Saclay, Assistance Publique-Hôpitaux de Paris (AP-HP), 11 rue Chardon-Lagache, 75016 Paris, France.
Pharmaceutics. 2020 Aug 8;12(8):746. doi: 10.3390/pharmaceutics12080746.
Presenting many advantages, solid oral dosage forms (SODFs) are widely manufactured and frequently prescribed in older populations regardless of the specific characteristics of patients. Commonly, patients with dysphagia (swallowing disorders) experience difficulties taking SODFs, which may lead to non-adherence or misuse. SODF characteristics (e.g., size, shape, thickness) are likely to influence swallowability. Herein, we used the acceptability reference framework (the ClinSearch acceptability score test (CAST))-a 3D-map juxtaposing two acceptability profiles-to investigate the impact of tablet size on acceptability. We collected 938 observer reports on the tablet intake by patients ≥65 years in hospitals or care homes. As we might expect, tablets could be classified as accepted in older patients without dysphagia ( = 790), while not in those with swallowing disorders ( = 146). However, reducing the tablet size had a significant impact on acceptability in this subpopulation: tablets <6.5 mm appeared to be accepted by patients with swallowing disorders. Among the 309 distinct tablets assessed in this study, ranging in size from 4.7 to 21.5 mm, 83% are ≥6.5 mm and consequently may be poorly accepted by institutionalized older people and older inpatients suffering from dysphagia. This underlines the need to develop and prescribe medicines with the best adapted characteristics to reach an optimal acceptability in targeted users.
固体口服剂型（SODFs）具有诸多优点，无论患者的具体特征如何，在老年人群中都被广泛生产且经常被处方使用。通常，吞咽困难（吞咽障碍）患者服用SODFs会有困难，这可能导致不依从或误用。SODF的特性（如大小、形状、厚度）可能会影响吞咽能力。在此，我们使用了可接受性参考框架（ClinSearch可接受性评分测试（CAST））——一种并列两个可接受性概况的三维地图——来研究片剂大小对可接受性的影响。我们收集了938份关于≥65岁患者在医院或疗养院服用片剂的观察报告。正如我们所预期的，片剂在无吞咽困难的老年患者中（=790）可被归类为可接受，而在有吞咽障碍的患者中则不然（=146）。然而，减小片剂大小对该亚组的可接受性有显著影响：<6.5毫米的片剂似乎能被有吞咽障碍的患者接受。在本研究评估的309种不同片剂中，大小从4.7毫米到21.5毫米不等，83%的片剂≥6.5毫米，因此可能不被机构化老年人和患有吞咽困难的老年住院患者所接受。这突出了开发和处方具有最适配特性的药物以在目标用户中达到最佳可接受性的必要性。
