Does the Formulation of Oral Solid Dosage Forms Affect Acceptance and Adherence in Older Patients?:A Mixed Methods Systematic Review


OBJECTIVES: Age-related changes mean that the older population can encounter barriers toward taking medication orally. Further work is needed to identify the characteristics of oral solid dosage forms that will improve patient acceptance and adherence. The aim of this systematic review was to identify if and how formulation aspects of oral solid dosage forms affect acceptance and adherence in older people. DESIGN: Mixed methods systematic review using a data-based convergent synthesis design. SETTING AND PARTICIPANTS: Articles were selected if they included participants aged 60 years and older, or included health care professionals, social care professionals, and informal carers of patients aged 60 years and older. METHODS: A systematic search of the following databases was undertaken: Web of Science, MEDLINE, Scopus, and The Cochrane Databases. The search of databases was supplemented by a search of gray literature, and reference lists of included papers were manually searched. RESULTS: A total of 16 studies were included in the final synthesis. Three themes were generated from the thematic analysis: (1) dimensions, (2) palatability, and (3) appearance. The dimensions and palatability are often modified to improve swallowability by breaking tablets in half or taste masking with food. Polypharmacy can lead to patients using the appearance to identify tablets; however, this can lead to confusion when products appear similar. No study was identified that explored formulation characteristics across all 3 categories directly in the older population. CONCLUSION AND IMPLICATIONS: Manufacturers should take into account practical problems older people may encounter when considering the dimensions, palatability, and appearance of the final drug product. These characteristics should be optimized to aid visual identification and swallowability. Medical providers and pharmacists have an important role in ensuring that these patient-centric drug products are prescribed and dispensed appropriately so that patients receive the most suitable formulation.

Publication DOI:
Divisions: College of Health & Life Sciences > Aston Pharmacy School
College of Health & Life Sciences > Chronic and Communicable Conditions
College of Health & Life Sciences
Additional Information: © 2020 AMDA The Society for Post-Acute and Long-Term Care Medicine. This is an open access article under the CC BY-NC-ND license (
Uncontrolled Keywords: Oral solid formulation,acceptance,adherence,older people,systematic review,Nursing(all),Health Policy,Geriatrics and Gerontology
Publication ISSN: 1538-9375
Last Modified: 28 May 2024 07:15
Date Deposited: 02 Apr 2020 11:08
Full Text Link:
Related URLs: https://www.jam ... 0146-8/fulltext (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Review article
Published Date: 2020-08
Published Online Date: 2020-03-26
Accepted Date: 2020-03-01
Authors: Shariff, Zakia B
Dahmash, Dania T
Kirby, Daniel J (ORCID Profile 0000-0002-0878-2620)
Missaghi, Shahrzad
Rajabi-Siahboomi, Ali
Maidment, Ian D (ORCID Profile 0000-0003-4152-9704)

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