Patient Centric Medicine Design:An Investigation into Understanding and Enhancing Older People’s Adherence to and Acceptance of Oral Solid Dosage Forms

Abstract

Background: Older people are increasingly taking a greater number of medications. Optimising the use of these medicines is important to ensure that patients are taking their medication as intended. Patient centric medicine design can help ensure that the needs of the target population are identified and addressed during the manufacture of pharmaceuticals. Aim: To investigate the characteristics of oral solid dosage forms that contribute to age appropriate, patient centric medicines that help to improve medication adherence and acceptance in older people. Methods, results and key findings: Firstly, a systematic review investigating if and how the formulation of oral solid dosage forms affects adherence and acceptance in older people was conducted. Characteristics were categorised into three inter-related topic areas: dimensions, palatability and appearance. A major finding of this review was the limited number of studies published; in particular, a lack of qualitative studies. This was addressed in the second stage of this project. Fifty-two semi-structured interviews were conducted with older people, informal (family) carers, and health and social care professionals. Formulation characteristics were found to impact three key stages of the medication taking process: medication identification and memorability, medication handling, and swallowability. Health and social care professionals were found to have a key role in ensuring patient centric medicines are provided; however, this role is dependent on several key barriers and facilitators. The final stage used results from the semi structured interviews to create oval, shield and biconcave disc shaped models using 3D printing. Conclusions: The development of patient centric medicines for the older population requires a holistic, patient-centric approach. Manufacturers should consider the dimensions, palatability and appearance alongside the medication taking process. In all cases, patient centric medicines must then be prescribed, dispensed and administered appropriately so that patients receive the most suitable formulation.