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. 2020 Aug 8;12(8):746.
doi: 10.3390/pharmaceutics12080746.

Acceptability in the Older Population: The Importance of an Appropriate Tablet Size

Thibault Vallet  1 , Hugues Michelon  2 , Mine Orlu  3 , Yogini Jani  4 , Patrick Leglise  5 , Sandra Laribe-Caget  6 , Matthieu Piccoli  7 , Aurélie Le Fur  1 , Fang Liu  8 , Fabrice Ruiz  1 , Vincent Boudy  9   10
Affiliations

Acceptability in the Older Population: The Importance of an Appropriate Tablet Size

Thibault Vallet et al. Pharmaceutics. .

Abstract

Presenting many advantages, solid oral dosage forms (SODFs) are widely manufactured and frequently prescribed in older populations regardless of the specific characteristics of patients. Commonly, patients with dysphagia (swallowing disorders) experience difficulties taking SODFs, which may lead to non-adherence or misuse. SODF characteristics (e.g., size, shape, thickness) are likely to influence swallowability. Herein, we used the acceptability reference framework (the ClinSearch acceptability score test (CAST))-a 3D-map juxtaposing two acceptability profiles-to investigate the impact of tablet size on acceptability. We collected 938 observer reports on the tablet intake by patients ≥65 years in hospitals or care homes. As we might expect, tablets could be classified as accepted in older patients without dysphagia (n = 790), while not in those with swallowing disorders (n = 146). However, reducing the tablet size had a significant impact on acceptability in this subpopulation: tablets <6.5 mm appeared to be accepted by patients with swallowing disorders. Among the 309 distinct tablets assessed in this study, ranging in size from 4.7 to 21.5 mm, 83% are ≥6.5 mm and consequently may be poorly accepted by institutionalized older people and older inpatients suffering from dysphagia. This underlines the need to develop and prescribe medicines with the best adapted characteristics to reach an optimal acceptability in targeted users.

Keywords: CAST (ClinSearch acceptability score test); SODF; acceptability; formulation; medicine; older population; size.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Acceptability profiles of tablets in the older patients with swallowing disorders (SD+) and without swallowing disorders (SD−).
Figure 2
Figure 2
Acceptability profiles of tablets smaller than 6.5 mm and tablets which are 6.5 mm and larger in the older patients with swallowing disorders (SD+).
Figure 3
Figure 3
Acceptability profiles of tablets smaller than 6 mm and tablets smaller than 7.5 mm in the older patients with swallowing disorders (SD+).
See this image and copyright information in PMC

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