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Observational Study
. 2018 May 7;35(7):136.
doi: 10.1007/s11095-018-2424-3.

A Decision Support Tool Facilitating Medicine Design for Optimal Acceptability in The Older Population

Thibault Vallet  1 , Emilie Belissa  2 , Sandra Laribe-Caget  3 , Alain Chevallier  4 , François-Xavier Chedhomme  4 , Patrick Leglise  5 , Matthieu Piccoli  4 , Hugues Michelon  6 , Vanessa Bloch  7   8 , Sylvie Meaume  3 , Anne-Sophie Grancher  3 , Nathalie Bachalat  5 , Imad Boulaich  5 , Fattima Abdallah  5 , Maite Rabus  5 , Jean-Paul Rwabihama  5 , Annie-Claude Ribemont  5 , Celia Lachuer  5 , Ines Perquy  4 , Laurent Lechowski  6 , Anne Delahaye  6 , Mathieu Depoisson  9 , Yann Orven  9 , Caroline Guinot  7 , Stephane Gibaud  10 , Corinne Michel  11 , Abdel Mahiou  11 , Sid-Ahmed Belbachir  11 , Jean-Hugues Trouvin  2   8 , Amelie Dufaÿ-Wojcicki  2 , Vincent Boudy  2   8 , Fabrice Ruiz  12
Affiliations
Observational Study

A Decision Support Tool Facilitating Medicine Design for Optimal Acceptability in The Older Population

Thibault Vallet et al. Pharm Res. .

Abstract

Purpose: Medicine acceptability, which is of the utmost importance for vulnerable patients' adherence, is driven by both user and product characteristics. Herein, a novel multivariate approach integrating the many aspects of acceptability is used to discriminate positively and negatively accepted medicines in the older population.

Methods: An observational study was carried out in eight hospitals and eight nursing homes to collect a large set of real-life data on medicines uses in older patients (≥65 years). Mapping and clustering explored these multiple observational measures and summarised the main information into an intelligible reference framework. Resampling statistics were used to validate the model's reliability.

Results: A three-dimensional map and two clusters defining acceptability profiles, as positive or negative, emerged from the 1079 evaluations. Factors of interest (medicines, user features…) were positioned on the map at the barycentre of their evaluations and assigned to an acceptability profile. Focusing on patients' ability to swallow, we have highlighted the tool's efficacy in demonstrating the impact of user features on medicine acceptability.

Conclusions: This multivariate approach provides a relevant judgement criterion for this multi-dimensional concept. Facilitating the choice of the most appropriate dosage form to achieve optimal acceptability in a targeted population, this tool is of real potential to improve clinical decisions.

Keywords: drug formulation; elderly; medicine acceptability; multivariate analysis; swallowability.

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Figures

Fig. 1
Fig. 1
Acceptability map
Fig. 2
Fig. 2
Medicine “Y” acceptability score (zoom on the acceptability map)
Fig. 3
Fig. 3
Influence of swallowing disorder on acceptability score of medicine “Y” (zoom on the acceptability map)
See this image and copyright information in PMC

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