Acceptability in the Older Population: The Importance of an Appropriate Tablet Size
Thibault Vallet,
Hugues Michelon,
Mine Orlu,
Yogini Jani,
Patrick Leglise,
Sandra Laribe-Caget,
Matthieu Piccoli,
Aurélie Le Fur,
Fang Liu,
Fabrice Ruiz,
Vincent Boudy
Affiliations
Thibault Vallet
ClinSearch, 110 Avenue Pierre Brossolette, 92240 Malakoff, France
Hugues Michelon
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
Mine Orlu
Department of Pharmaceutics, UCL School of Pharmacy, 29–39 Brunswick Square, London WC1N 1AX, UK
Yogini Jani
Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK
Patrick Leglise
Pharmacy department, Hôpital Joffre Dupuytren, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), 1 rue Eugène Delacroix, 91210 Draveil, France
Sandra Laribe-Caget
Pharmacy department, Hôpital Rothschild, Hôpitaux Universitaires Est Parisien, Assistance Publique-Hôpitaux de Paris (AP-HP), 5 Rue Santerre, 75012 Paris, France
Matthieu Piccoli
Hôpital Broca, Hôpitaux Universitaires Paris Centre, Assistance Publique-Hôpitaux de Paris (APHP), 54–56 Rue Pascal, 75013 Paris, France
Aurélie Le Fur
ClinSearch, 110 Avenue Pierre Brossolette, 92240 Malakoff, France
Fang Liu
Department of Clinical and Pharmaceutical Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
Fabrice Ruiz
ClinSearch, 110 Avenue Pierre Brossolette, 92240 Malakoff, France
Vincent Boudy
Unité de R&D Galénique, Agence Générale des Equipements et Produits de Santé (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), 7 rue du Fer À Moulin, 75005 Paris, France
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 (n = 790), while not in those with swallowing disorders (n = 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.
