title: Methods of administering oral formulations and child acceptability.
abstract: BACKGROUND
  Children may be unable or unwilling to swallow medicines. In order to avoid or accommodate any such problems, parents may decide to administer medicines other than intended. The aim of this study was to investigate how parents administered four oral placebo formulations to infants and preschool children and how the applied methods correlated with child acceptability.
  
  
  METHODS
  Parents were asked to administer a 4 mm mini-tablet, powder, suspension and syrup to their child twice on one day and to report the child characteristics and administration details in a participant diary.
  
  
  RESULTS
  A 151 children were included. The tablet, syrup and suspension were mostly given on their own, whereas the powder was commonly given with food or drink. Generally, the higher the child acceptability (VAS-score) of the first administration of a specific formulation, the less frequently its method of administration was changed. A change in the method of administration of the same formulation involving (a larger quantity of) food or drink generally resulted in a higher VAS-score.
  
  
  CONCLUSIONS
  The joint administration of medicines with food or drink is an effective strategy to ensure swallowing. This study supports earlier findings that 4mm mini-tablets are a suitable dosage form from infant age.
authors.affiliation: Medicines Evaluation Board in the Netherlands, Department of Chemical Pharmaceutical Assessments, Utrecht, The Netherlands(1); Utrecht University, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht, The Netherlands. Electronic address: da.v.riet@cbg-meb.nl.
authors.forename: Diana A
authors.initials: DA
authors.lastname: van Riet-Nales
authors.affiliation: National Institute for Public Health and the Environment, Department of Statistics, Modelling and Data Management (SMG), Bilthoven, The Netherlands.
authors.forename: José A
authors.initials: JA
authors.lastname: Ferreira
authors.affiliation: Medicines Evaluation Board in the Netherlands, Department of Chemical Pharmaceutical Assessments, Utrecht, The Netherlands(1); Utrecht University, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht, The Netherlands.
authors.forename: Alfred F A M
authors.initials: AF
authors.lastname: Schobben
authors.affiliation: Stichting Thuiszorg en Maatschappelijk Werk Rivierenland, Section Child Care, Tiel, The Netherlands.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: de Neef
authors.affiliation: Utrecht University, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht, The Netherlands; University Medical Centre Utrecht, Department of Clinical Pharmacy, Utrecht, The Netherlands.
authors.forename: Toine C G
authors.initials: TC
authors.lastname: Egberts
authors.affiliation: University Medical Centre Utrecht, Department of Clinical Pharmacy, Utrecht, The Netherlands.
authors.forename: Carin M A
authors.initials: CM
authors.lastname: Rademaker
mesh_terms: D000284:Administration, Oral; D000367:Age Factors; D002626:Chemistry, Pharmaceutical; D002675:Child, Preschool; D018592:Cross-Over Studies; D003679:Deglutition; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010342:Patient Acceptance of Health Care; D019999:Pharmaceutical Solutions; D011208:Powders; D013535:Suspensions; D013607:Tablets
chemical_list: D019999:Pharmaceutical Solutions; D011208:Powders; D013535:Suspensions; D013607:Tablets
keywords: Administration; Age-appropriate; Child; Formulation; Mini-tablet; Mixing; Oral