I Spy with My Little Eye: A Paediatric Visual Preferences Survey of 3D Printed Tablets

Abstract

3D printing (3DP) in the pharmaceutical field is a disruptive technology that allows the preparation of personalised medicines at the point of dispensing. The paediatric population presents a variety of pharmaceutical formulation challenges such as dose flexibility, patient compliance, taste masking and the fear or difficulty to swallow tablets, all factors that could be overcome using the adaptable nature of 3DP. User acceptability studies of 3D printed formulations have been previously carried out in adults; however, feedback from children themselves is essential in establishing the quality target product profile towards the development of age-appropriate medicines. The aim of this study was to investigate the preference of children for different 3D printed tablets (Printlets™) as an important precursor to patient acceptability studies. Four different 3DP technologies; digital light processing (DLP), selective laser sintering (SLS), semi-solid extrusion (SSE) and fused deposition modeling (FDM) were used to prepare placebo printlets with similar physical attributes including size and shape. A single-site, two-part survey was completed with participants aged 4-11 years to determine their preference and opinions based on visual inspection of the printlets. A total of 368 participants completed an individual open questionnaire to visually select the best and worst printlet, and 310 participants completed further non-compulsory open questions to elaborate on their choices. Overall, the DLP printlets were the most visually appealing to the children (61.7%) followed by the SLS printlets (21.2%), and with both the FDM (5.4%) and SSE (11.7%) printlets receiving the lowest scores. However, after being informed that the SSE printlets were chewable, the majority of participants changed their selection and favoured this printlet, despite their original choice, in line with children's preference towards chewable dosage forms. Participant age and sex displayed no significant differences in printlet selection. Printlet descriptions were grouped into four distinct categories; appearance, perceived taste, texture and familiarity, and were found to be equally important when creating a quality target product profile for paediatric 3D printed formulations. This study is the first to investigate children's perceptions of printlets, and the findings aim to provide guidance for further development of paediatric-appropriate medicines using different 3DP technologies.

Keywords: 3D printed drug products; MEDIMAKER 3D printing technology; additive manufacturing; pediatrics; personalized pharmaceuticals; printing formulations and dosage forms; printlets; three-dimensional printing; visual preference.

Figure 1

Placebo printlets fabricated with the four different 3DP technologies. From left to right: digital light processing (DLP), selective laser sintering (SLS), semi-solid extrusion (SSE) and fused deposition modelling (FDM).

Figure 2

Printlet visual preference results summary (n = 368).

Figure 3

Printlet visual preference results summary after the participants knew the SSE printlet is a chewable form (n = 368).

Figure 4

Printlet visual preference results based on sex: (a) Boys and (b) girls.

Figure 5

Printlet visual preference results based on different age groups (n = 368).

Figure 6

Overall visual description data for all printlets based on the selected 3D printing (3DP) technology (DLP n = 244; SLS n = 170; SSE n = 125; FDM n = 92).

Figure 7

Summary of visual description data for printlets manufactured by different 3DP technologies based on four categories: Appearance, perceived taste, texture and familiarity (DLP n = 244, SLS n = 170, SSE n = 125, FDM n = 92). Each pie chart shows the percentage of comments given for each printlet. The four categories of each pie chart are split into ‘positive’ and ‘negative’ comments, which correspond to each 3DP technology, with positive comments represented by darker shades and negative comments by lighter shades.