title: Devices for oral and respiratory paediatric medicines: What do healthcare professionals think?
abstract: Medical devices are crucial for the proper administration of paediatric medicines to children, but handling and dosing errors commonly appear in daily practice. As both the understanding and the usage of medical devices for oral and respiratory drug administration are heterogeneous among patients and caregivers, the European Paediatric Formulation Initiative (EuPFI) consortium performed a European survey among healthcare professional stakeholders in France, Germany, Hungary, Italy, Spain and UK. The results show country- and age-dependent usage of devices for oral administration of liquid formulations, with a clear preference for oral droppers and syringes in the neonatal phase and in early infancy. In older children, spoons and cups are more frequently used although it is recognized that they may fail in delivering correct doses. The percentage of medicinal products definitely requiring an oral administration device was estimated as 68.8% by the participants. The survey elaborated a similar usage pattern for medical devices for respiratory drug delivery: in young children drug solutions are nebulized, using face-masks and subsequently valved holding chambers or spacers, with increasing age metered-dose inhalers and later dry powder inhalers are preferably used. 56% of the responding healthcare professionals believed that providing an administration device helps to ensure that the patient receives the correct dose of medicine, and 41% agreed that patients must be given an administration device with each supply of medicine. Interestingly, 6.7% thought that patients tend not to use the device provided and remarkably 25.4% stated that patients already have a device. Although there is the highest count of treated children with device supply in Germany and Hungary, there are no observed significant differences in the six investigated European countries (p=0.057). Patient difficulties in correct oral and respiratory device use were identified by respondents and potential solutions discussed.
authors.affiliation: Jenny Walsh Consulting Ltd., BioCity Nottingham, Pennyfoot Street, Nottingham NG1 1GF, UK. Electronic address: jenny@jennywalshconsulting.com.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Walsh
authors.affiliation: Sanofi R&D, Pharmaceutical Sciences Department, 371 Rue du Professeur Blayac, 34184 Montpellier Cedex 04, France. Electronic address: marie-christine.math@sanofi.com.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Math
authors.affiliation: Institute of Pharmaceutics and Biopharmaceutics, Heinrich-Heine-University Duesseldorf, Universitaetsstrasse 1,40225 Duesseldorf, Germany. Electronic address: joerg.breitkreutz@uni-duesseldorf.de.
authors.forename: Jörg
authors.initials: J
authors.lastname: Breitkreutz
authors.affiliation: Department of Communication Studies and Media Research, LMU Munich, Oettingenstraße 67, 80538 Munich, Germany. Electronic address: thomas.zerback@ifkw.lmu.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Zerback
authors.affiliation: Boehringer Ingelheim Pharma GmbH & Co. KG, Analytical Development, Packaging Development Center, Binger Straße 173, 55216 Ingelheim am Rhein, Germany. Electronic address: herbert.wachtel@boehringer-ingelheim.com.
authors.forename: Herbert
authors.initials: H
authors.lastname: Wachtel
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D002648:Child; D016503:Drug Delivery Systems; D004864:Equipment and Supplies; D006282:Health Personnel; D006801:Humans; D011795:Surveys and Questionnaires
keywords: Dosing device; Oral administration; Paediatric; Respiratory device; Survey