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Pharm Res. 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.

Author information

1
ClinSearch, 110 Avenue Pierre Brossolette, 92240, Malakoff, France.
2
Département Recherche et Développement Pharmaceutique, Agence Générale des Equipements et Produits de Santé (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
3
Hôpital Rothschild, Groupe Hospitalier Universitaire Est Parisien, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
4
Hôpital Broca, Groupe Hospitalier Universitaire Paris Centre, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.
5
Hôpital Joffre Dupuytren, Groupe Hospitalier Universitaire Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Draveil, France.
6
Hôpital Sainte Périne, Groupe Hospitalier Universitaire Paris Ile-de-France Ouest, Assistance Publique- Hôpitaux de Paris (AP-HP), Paris, France.
7
Hôpital Fernand Widal, Groupe Hospitalier Universitaire Saint-Louis - Lariboisière - Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
8
Université Paris Descartes, Paris, France.
9
Hôpital Vaugirard, Groupe Hospitalier Universitaire Paris Ouest, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
10
Centre Hospitalier de l'Ouest Vosgien, Neufchâteau, France.
11
Hôpital René Muret, Groupe Hospitalier Universitaire Paris Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris (AP-HP), Sevran, France.
12
ClinSearch, 110 Avenue Pierre Brossolette, 92240, Malakoff, France. fabrice.ruiz@clinsearch.net.

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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