title: Modification of oral dosage forms for the older adult: An Irish prevalence study.
abstract: Age-related pharmacological changes complicate oral dosage form (ODF) suitability for older adults. The aim of this study was to investigate the appropriateness of ODF for older adults by determining the prevalence of ODF modifications in an aged care facility in Ireland. Drug charts for eligible patients were obtained. Details of all medications administered were recorded. ODF modifications were examined to determine if they were evidence-based: defined as complying with the product license or best practice guidelines (BPG). In total, of 111 patients, 35.1% received at least one modified medicine. Medicines were most commonly modified to facilitate fractional dosing (82.0%). Of the 68 instances of medicine modification, 35.3% complied with the product license. Of the 44 unlicensed modifications, 14 complied with BPG. Therefore, 44.1% of modifications were not evidence-based. This study highlights that clinicians have to routinely tailor commercial ODF to meet older patients' needs despite the lack of an evidence-base for almost half of these modifications. The main factor contributing to these modifications is the lack of appropriate, licensed dosage forms. However, reimbursement policies also play a role. Research is needed to optimise medicine administration and to provide clinicians with much needed evidence to support their daily practice.
authors.affiliation: Pharmaceutical Care Research Group, School of Pharmacy, University College Cork (UCC), Cork, Ireland. Electronic address: a.mcgillicuddy@umail.ucc.ie.
authors.forename: Aoife
authors.initials: A
authors.lastname: Mc Gillicuddy
authors.affiliation: Pharmaceutical Care Research Group, School of Pharmacy, University College Cork (UCC), Cork, Ireland.
authors.forename: Maria
authors.initials: M
authors.lastname: Kelly
authors.affiliation: Medical Education Unit, University College Cork (UCC), Cork, Ireland; Marymount University Hospital and Hospice, Cork, Ireland.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sweeney
authors.affiliation: Marymount University Hospital and Hospice, Cork, Ireland.
authors.forename: Ann
authors.initials: A
authors.lastname: Carmichael
authors.affiliation: School of Pharmacy, University College Cork (UCC), Cork, Ireland.
authors.forename: Abina M
authors.initials: AM
authors.lastname: Crean
authors.affiliation: Pharmaceutical Care Research Group, School of Pharmacy, University College Cork (UCC), Cork, Ireland; Pharmacy Department, Mercy University Hospital, Cork, Ireland.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Sahm
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004304:Dosage Forms; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D004364:Pharmaceutical Preparations / Q000008:administration & dosage* / Q000737:chemistry*; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D004304:Dosage Forms; D004364:Pharmaceutical Preparations
keywords: Dysphagia; Fractional dosing; Medication administration; Older patients; Oral dosage form modification