title: Palliative medicines for children - a new frontier in paediatric research.
abstract: OBJECTIVE
  This paper seeks to highlight from a UK perspective the current lack of a research evidence base in paediatric palliative care that has resulted in a paucity of available medicines with appropriate formulations (strength and dosage form) to provide symptom management for children with life-limiting illnesses and to raise awareness of this group of 'therapeutic orphans'. Currently, clinicians have limited, often unsuitable medication choices for their paediatric palliative care patients, with little hope of moving away from the status quo.
  
  
  RESULTS
  Most medicines used in children receiving palliative care are old and off-patent drugs, developed for and tested in an adult population. Many are not available in suitable formulations (dosage form and strength) for administration to children, and there are often no age-related profiles of adverse drug reactions or for safe dosing.
  
  
  CONCLUSIONS
  Existing regional paediatric palliative care networks and support organisations should lobby funding bodies and the academic community to support appropriate research for this group of therapeutic orphans. Support must also be provided to pharmaceutical companies in the development of suitable products with appropriate formulations.
authors.affiliation: UCL School of Pharmacy, London, UK.
authors.forename: Liz
authors.initials: L
authors.lastname: Jamieson
authors.affiliation: UCL School of Pharmacy, London, UK.
authors.forename: Ian C K
authors.initials: IC
authors.lastname: Wong
authors.affiliation: Louis Dundas Centre for Children's Palliative Care, Great Ormond Street Hospital, UCL Institute of Child Health, London, UK.
authors.forename: Finella
authors.initials: F
authors.lastname: Craig
authors.affiliation: CAG Lead Pharmacist Women and Children & Lead Clinical Pharmacist for Paediatrics, Barts Health NHS Trust, Pathology and Pharmacy Building, London, UK.
authors.forename: Nanna
authors.initials: N
authors.lastname: Christiansen
authors.affiliation: Helen & Douglas House Hospices, Oxford, Oxfordshire, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Brombley
authors.affiliation: UCL School of Pharmacy, London, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Tuleu
authors.affiliation: Helen & Douglas House Hospices, Oxford, Oxfordshire, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Harrop
mesh_terms: D035843:Biomedical Research / Q000379:methods* / Q000639:trends; D002648:Child; D016503:Drug Delivery Systems / Q000379:methods; D006801:Humans; D010166:Palliative Care / Q000379:methods* / Q000639:trends; D065126:Palliative Medicine / Q000379:methods* / Q000639:trends; D010372:Pediatrics / Q000379:methods* / Q000639:trends; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*
chemical_list: D004364:Pharmaceutical Preparations
keywords: end-of-life care; hospice care; medicines for children; paediatric medicines; paediatric palliative care; symptom management