Acceptability of Lansoprazole Orally Disintegrating Tablets in Patients with Gastro-Oesophageal Reflux Disease

Pilot comparison of the ease of swallowing of single tablet antiretroviral regimens

Daily adherence to lifelong antiretroviral therapy (ART) is required to achieve long term treatment success. However, patient preferences for ART tablet size have not been well studied. Our study assessed factors associated with the ease of swallowing (EoS) and tolerability of two placebo tablets representing and matching B/F/TAF (BPT) and DTG/ABC/3TC (DPT). Fifty ART-naïve patients were randomized into a two-period cross-over study. Likert scale (1-5) questionnaires were administered to assess patient factors influencing the ease of swallowing, adherence, home medications, medication preferences and perceptions. Comparisons were done using Student t-tests and ordinal regression. Participants were 64% female, 61% white, mean age 43 years, and taking a mean (median) of 4(1) pills/day. BPT was reported to be easier than DPT with ease of swallowability 1.76 vs. 2.42 (p < 0.001) (1 = very easy). DPT tablet was correctly perceived as larger than BPT (p < 0.001); with both tablets perceived as smaller than actual size (p < 0.001). EoS of either tablet was positively associated with the EoS of the largest home tablet medication (p = 0.021, p = 0.03). Patient's perceptions of EoS can affect their medication adherence, especially in HIV, and should be considered in treatment regimens.

Discussion of prevalence and management of discomfort when swallowing pills: orodispersible tablets expand treatment options in patients with depression

Many patients experience discomfort when trying to swallow tablets and capsules, but this issue is rarely discussed between patients and physicians. Discomfort when swallowing pills is common and arises due to the morphology of the oropharynx and esophagus, which are not well suited to swallowing rigid objects of small volume. Compliance with medication is poor in patients with chronic diseases such as depression. An inability or unwillingness to swallow medication can further reduce acceptance of and compliance with medication, which has an impact on effectiveness. Recognition that patient acceptance of prescribed medication is an important component of compliance has led to the development of pill-swallowing training programs and alternative formulations. Orodispersible tablets do not need to be taken with water and can be packaged discreetly in single doses. Orodispersible tablets have been shown to be effective in a number of therapy areas including depression.

Use of clinical simulation centers in health professions schools for patient-centered research

INTRODUCTION

Professional practice assessment research performed in clinical simulation centers is a research method that also creates opportunity for multidisciplinary investigator collaboration.

METHODS

Nursing and pharmacy school clinical simulation laboratories at the University of Utah were used to conduct time-and-motion (TM) studies of medication dispensing and administration. Time data were then used to determine personnel and supply costs associated with different medication dosage forms and delivery methods. A case study from a completed research project describes the use of TM and activity-based costing analyses to assess medication preparation and administration time and cost differences related to three proton pump inhibitor dosage forms. Standardized doses were prepared by pharmacists or technicians and subsequently administered by nurses to a mannequin in the simulation center by seven different administration scenarios. Simulation scenarios were developed in a manner that held the independent variables constant, so that time and cost differences between dosage forms and administrations methods could be quantified.

RESULTS

A detailed example of one approach to use of simulation centers for TM studies and activity-based costing analyses is provided. The advantages of isolating processes of interest from the day-to-day complexity of patient care are shown. Results illustrate how simulations based on professional school simulation centers may be used to assess health care processes at the microlevel with potential for projection to the macrolevel.

CONCLUSIONS

Studies based on health professional schools simulation centers may offer a novel method of evaluating health care processes at the microlevel.

Improving medication compliance in patients with depression: Use of orodispersible tablets

The treatment of major depressive disorder requires prolonged pharmacotherapy with antidepressants in order to resolve the current episode and reduce the risk for recurrence of depressive symptoms. Such prolonged therapy requires considerable commitment on the part of patients to take their medication as prescribed. Medication compliance is often poor among psychiatric patients, including those with major depressive disorder; this can result in poor long-term outcomes and, ultimately, treatment failure. The onus lies with the prescribing physician to support patients in complying with their medication regimen. Establishing and maintaining a supportive therapeutic relationship is an essential foundation for ensuring patient compliance. Difficulty in swallowing conventional tablets and capsules has emerged as an additional factor in medication noncompliance and has led to the development of alternative drug delivery strategies such as orodispersible tablets (ODTs). ODTs are associated with improved medication compliance compared with traditional tablet formulations. An ODT formulation of the antidepressant mirtazapine has been available since 2001 and an ODT formulation of escitalopram is currently in development. Such formulations offer convenient alternatives to traditional tablets and may support patient compliance with extended therapy. This review discusses practical methods of improving compliance in patients with depression with a particular focus on ODTs.

[A study on the subjective compliance and acceptance of oral lanzoprazole in traumatology. The ECOFT-TR Study]

OBJECTIVE

To assess compliance with oral lansoprazole disintegrating tablets (LODT) in patients treated by traumatology specialists.

MATERIAL AND METHOD

A multicenter, observational, cross-sectional study involving 370 traumatology specialists and patients aged 18 or more. Study logistics were sponsored by Almirall Laboratories, S.A.; neither investigators nor patients received any economic compensation for their participation. Patient subjective compliance with LODT was assessed with the Haynes Sackett test. Acceptability was based on patients' global assessments of the drug's organoleptic characteristics and properties of use, and preferences regarding previous treatments, recorded by means of a self-administered 15-item ad hoc questionnaire with a 2-5-point Likert-type scale, that patients fulfilled once.

RESULTS

One thousand and eighty five patients were evaluable for the main endpoint. Mean age was 56.09±13.8 years; 56.77% were women. Mean treatment duration was 51.24±38.8 days. 94.74% of the patients complied with the treatment. Mean percentage of compliance was 94.5±12.12; 91.09% of patients rated the treatment as «acceptable or highly acceptable». No significant differences were observed between compliant and non-compliant patients in terms of demographic or clinical variables. Mean percentage of compliance was significantly higher among patients without concomitant illness or treatment and without difficulties in taking tablets. One non-serious adverse reaction was reported in one (0.09%) patient.

CONCLUSIONS

Compliance with lansoprazole orally disintegrating tablets was high. Patients reported that this formulation improved their compliance and that they preferred LODT to previous medication. Tolerability was excellent.