Pharmacy - Journal Articles
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Item Challenges prescribing and dispensing oral antibiotics with poor palatability for paediatric patients: A qualitative interview study with GPs and pharmacists(Elsevier Inc., 2024-11-29) Elgammal, Ayat; Ryan, Joseph; Bradley, Colin; Crean, Abina; Bermingham, Margaret; Science Foundation IrelandBackground: Poor palatability of antibiotics is a key cause for non-adherence to antibiotic treatment among children. Failure to complete antibiotic treatment because of poor palatability can cause disease recurrence and may contribute to increasing rates of antimicrobial resistance. The aim of this study was to investigate the experience and challenges faced by general practitioners (GPs) and community pharmacists regarding prescribing and dispensing oral liquid antibiotics for children and the impact of poorly palatable antibiotic formulations on patients and the health-system. Methods: One-to-one semi-structured interviews with GPs and pharmacists were conducted via an online video-conferencing platform. Data were analysed using thematic analysis. Results: Twenty participants (7 GPs and 13 pharmacists) were interviewed. Three main themes and eight subthemes were identified. Theme 1: challenges reported by GPs and pharmacists included four subthemes; (i) factors affecting prescribing and dispensing antibiotics, (ii) reasons to select poorly palatable antibiotics, (iii) palatability discussion with parents, and (iv) formulation factors affecting oral liquid antibiotic acceptability. Theme 2: the impact of prescribing or dispensing poorly palatable oral liquid antibiotics encompassed two sub themes; (i) patient impact and (ii) health-system impact. Theme 3: overcoming palatability challenges involved two subthemes; (i) raising awareness of flavour and palatability issues among healthcare professionals and (ii) counselling parents while prescribing and before dispensing. Conclusions: There is a need to increase palatability awareness among healthcare professionals and parents. The development of more palatable oral liquid formulations can play a role in improving prescribing and medicines taking practices.Item Flucloxacillin formulation odour acceptability: A human sensory assessment(Elsevier B.V., 2025-03-13) Elgammal, Ayat; Sheehan, Liz; Shine, Margaret; Mohamed, Reda; Kilcawley, Kieran; Skibinska, Iwona; Bermingham, Margaret; Crean, Abina; Research IrelandPalatability influences a medicine's acceptability. While medicine's taste and their acceptability have been explored, the relationship between a medicine's odour and its acceptability has received less attention. In this study, the odour acceptability of a range of oral flucloxacillin formulations was assessed by healthy adult volunteers. Flucloxacillin was chosen as it is reported to be malodourous and found to be poorly palatable by children. The odour of a commercial flucloxacillin solution and capsule formulation were rated as acceptable. The commercial solution odour was described as fruity, and aromatic, while the commercial capsule was described as odourless. An unformulated flucloxacillin solution and flucloxacillin minitablets were deemed to have an unacceptable odour described as pungent, musty, plastic, and rotten. The odour of flucloxacillin minitablets including silica was deemed as odourless and acceptable. The ability of silica to suppress flucloxacillin's malodour was attributed to its adsorption of malodourous volatile compounds. Malodourous volatile sulphur compounds, produced during flucloxacillin degradation, were identified by GC-MS in the headspace of an unformulated flucloxacillin solution. The volunteers' smell acuity was assessed and found to be normosmic or microsmic, except for one volunteer who was anosmic (odour blindness). While the odour assessments of normosmic and microsmic volunteers generally aligned, the anosmic volunteer's assessments were contrary to the general findings. This study highlights the ability of formulation to improve the odour acceptability of flucloxacillin, it demonstrates the capability of silica to suppress drug malodour, and determines the importance of volunteer smell acuity screening during medicine odour sensory studies.Item Opinions of visually impaired adults on the care provided at community pharmacies: a qualitative interview study(Springer Nature Switzerland AG, 2025-03-13) Roche Ryan, Ellen; Bennett-Lenane, HarrietBackground: Adults who are Visually Impaired (VI) often experience challenges in taking medications and interacting with healthcare settings. Aim: The aims of this study were to (1) explore the opinions of VI adults regarding care provided at community pharmacies in Ireland and (2) identify patient recommendations for improved care. Method: Semi-structured interviews were conducted using a topic guide via telephone or videoconference with VI adults who visit community pharmacies in Ireland. Interviewees were recruited on a voluntary basis using a mix of purposive, convenience and snowball sampling. Interviews were recorded, transcribed and carried out until theoretical data saturation. The Braun and Clarke approach was used for thematic data analysis using NVivo software. Results: Four major themes emerged from eighteen interviews. These were staff awareness, medicines information accessibility, physical inaccessibility and positive supports. Interviewees identified how open communication and close professional relationships between staff and VI adults could be influential in overcoming a perceived lack of independence and privacy currently experienced. Need for staff awareness training, improved provision of medicines information, improved physical accessibility of pharmacy layouts and use of mobile application as assistive technologies were also recommended. Conclusion: This study provides the first qualitative exploration of care provided to VI adults by community pharmacies in Ireland. Based on personal experiences, interviewees recommended mostly minor adjustments to pharmacy practice to increase accessibility and help provide improved care for this cohort when visiting a pharmacy. This work represents a springboard for future research involving bespoke interventions and tailored guidance for pharmacy teams.Item Mechanistic investigation into the phase separation behavior of soluplus in the presence of biorelevant media(ACS American Chemical Society, 2025) Lange, Justus Johann; Senniksen, Malte Bøgh; Wyttenbach, Nicole; Page, Susanne; Bateman, Lorraine M.; O’Dwyer, Patrick J.; Saal, Wiebke; Kuentz, Martin; Griffin, Brendan T.; Horizon 2020More than a decade since its introduction, the polymeric excipient Soluplus continues to receive considerable attention for its application in the development of amorphous solid dispersions (ASDs) and its utility as a solubilizer for drugs exhibiting solubility limited absorption. While it is well-recognized that Soluplus forms micelles, the impact of its lower critical solution temperature of approximately 40 °C remains an underexplored aspect. This study investigated the phase behavior of Soluplus in fasted-state simulated intestinal fluid (FaSSIF-V1). It was demonstrated that Soluplus forms a dispersed polymer-rich coacervate phase, which coexists with Soluplus micelles at 37 °C. This behavior was confirmed by cloud point measurements, visually discernible phases after centrifugation, as well as multi-angle dynamic light scattering (MADLS) measurements, and quantitative 1H-nuclear magnetic resonance (NMR) spectroscopy of Soluplus concentrations in the supernatant pre- and post-centrifugation. The practical relevance of these findings was contextualized by solvent shift experiments and dissolution testing of spray-dried ASD. The results demonstrated that the poorly water-soluble drug RO6897779 resided in a polymer-rich coacervate phase and was spun down during centrifugation, which resulted in an amorphous pellet exhibiting the characteristics of a viscous liquid. The entrapment of the drug within the polymer-rich phase was further analyzed by temperature- and time-dependent MADLS experiments. The findings of this study are of particular relevance for a mechanistic understanding, relevant to comprehending in vitro-in vivo relationships of Soluplus-based ASDs. Low sampled drug concentrations in FaSSIF-V1 at 37 °C may originate not only from limited drug release and precipitation but also from the formation of a drug-containing, polymer-rich Soluplus phase. Therefore, a liquid–liquid phase separation occurring from Soluplus-based formulations in a biorelevant medium can be excipient-driven, which is different from the common perception that phase separation in the solution state is triggered primarily by high drug concentrations exceeding their amorphous solubility.Item Medication management: supportive care medications in older adults with cancer(Wolters Kluwer Health, Inc., 2025-03) Walsh, Darren J.; Herledan, ChloéPurpose of review: This review raises awareness regarding the lack of data available for healthcare professionals caring for older adults with cancer when using supportive care medications. Recent findings: Guidelines for supportive cancer care lack concrete recommendations on the appropriate use of medications in older adults with cancer. Some guidelines, such as the National Comprehensive Cancer Network Older Adult Oncology guideline, contain vital information for prescribers to consider when choosing a supportive care medication. Information at present in most guidelines is generally vague, identifying areas where caution is required in older adults, without specific details. Summary: Research is needed to assess the efficacy and safety of supportive cancer care medications in older adults.
