Hiding taste, in particular using aromas and sweeteners: a means of increasing compliance with treatments. This is frequently used for OTC.
Paediatric medication: what if palatableness was all about the palate?
Compliance with treatments has become a public health issue because every year 100,000 hospital admissions could be avoided if prescriptions were followed better. On examining the reasons for failing to follow treatments more closely, bad taste is put forward as a main reason, especially in children*
Palatableness, defined as the overall appreciation of oral medication depending on its organoleptic properties (appearance, taste, after-taste, sensation on the tongue, texture, etc.) is a crucial factor in the acceptability of an oral form and, as a result, in the proper administration of the treatment. The medication colour, size and name are other factors that can influence the “perceived effectiveness” and therefore compliance with the treatment. Failing to follow a treatment can jeopardise its effectiveness and therefore lessen the expected results.
This is why laboratories are increasingly turning to palatableness (taste, sensation on the tongue, texture, etc.) which is considered to be important in the acceptance of medication, in particular when the active ingredients have an unpleasant taste.
Making sure paediatric treatment palatableness is acceptable is a key element in the Paediatric Investigation Plans (PIPs) and it must be assessed during clinical trials. Efforts remain to be made because acceptability studies usually occur at a late stage after development and formulation. In its 2012 recommendations on paediatric medication, the French National Academy of Pharmacy recommended that “pharmaceutical firms work with sensory analysis laboratories so that scientifically conducted palatableness studies carried out ethically provide the required information”. It also requests that formulations “using truly inert excipients for children” as well as new virtual taste assessment methods for children be developed.
Taste and OTC: never one without the other
Alongside paediatrics, OTC is another sector in which medication acceptability is important because patients are increasingly demanding.
Patients want to be treated but not at any taste.
In the formulation phases, the pharmaceutical industry mainly uses aromas, sweeteners and the coating of active ingredients to hide, or at least mitigate, the unpleasant taste of medication.
The need for aromas firstly depends on the pharmaceutical form: dry tablets and capsules need less than orodispersible and effervescent tablets as well as all oral liquid forms, drinkable solutions and syrups.
Target patient studies make it possible to determine medication aroma needs depending on different criteria such as the geographical area and eating habits**. According to a recent European study, sweet banana and caramel based notes are plebiscited by children. **
Similarly to the agri-food industry, the development of prescription and OTC medication can be based on consumer tests to validate product acceptability. Today, patients tend to have the same demands concerning medication as they do for consumer goods.
Paediatric and/or OTC medication, in addition to being easy-to-use and ready-to-use forms (such as orodispersible forms: liquid / powder pack sticks and orodispersible tablets) must also include the notion of pleasant taste. However, even if patients are considered to be consumers, the objective is not to change medication into confectionery, in particular for safety reasons.
Placing patients at the centre of pharmaceutical industry concerns should contribute to optimising patients’ compliance with treatments, from the youngest to the oldest.
Sources :https://www.gerpac.eu/formes-galeniques-pediatriques-pour-la-voie-orale-etudes-de-palatabilite
https://www.acadpharm.org/dos_public/Recommandations_mEdicaments_pEdiatriques_VF_2012.06.14.pdf
https://www.industriepharma.fr/aromes-l-otc-a-le-gout-du-consensus,44388
https://cdn-www.chu-nice.fr/assets/site/presse/cpmela.pdf
https://www.lareponsedupsy.info/ObservanceTherapeutique
https://www.lemoniteurdespharmacies.fr/ressources/upload/imgnewspha/depot/synthese-observatoire-observance.pdfobservance.pdf
*
https://www.ema.europa.eu/en/documents/scientific-guideline/reflection-paper-formulations-choice-paediatric-population_en.pdf
** 2018 GSK-UNITHER study from on a sample of 5000 persons from 5 europeen countries