(227) Assessment of Age-appropriateness and Acceptability of Oral Medicine Formulations for Children Less than 5 Years in a Low Income Setting

Background: It is challenging to accurately administer medicines to pediatric patients. This is largely due to lack of commercially available, age-appropriate and administration friendly formulations, mainly in low income countries. This forces caregivers and health professionals to manipulate adult dose and off-label use in pediatric population, which can increase the risk of adverse drug events and medication errors.

Objectives: To assess the Age-Appropriateness and Acceptability of Oral Medicine Formulations for Children Less than 5 Years in selected hospitals in a Low Income Setting

Methods: This hospital based cross -sectional study was conducted among 353 parents/immediate caregivers of less than 5years children treated in three randomly selected Hospitals in Tigray Regional State, Northern Ethiopia, form December 2022 to March 2023. The participants were recruited proportionally from the selected hospitals and simple random sampling method was used to select the participants in each hospital. A structured data collection form and face to face interview questionnaire was used to collect the data. The collected data were entered and analyzed by using SPSS version 22.0 statistical package.

Results: Of the total 353 parents/caregivers participated in the study 281(79.6%) of them were females. Bacterial infections and epilepsy of different types were the main diagnosis of the children and an average of 1.5 (SD, 0.73) oral medicine was prescribed per child. Majority 208(56.9%) of the parents/caregivers were perceived that the prescribed oral medicine formulations as unacceptable for their child. Of the total prescribed 533 oral medicine formulations 305(57.2%) of them were not age-appropriate for the age of the children. However, 195(63.9%) and 269(88.2%) of these 305 oral medicines; there is age-appropriate formulation alternatives in the Ethiopian national essential medicine list and the WHO list of essential medicine for pediatric population respectively. Regarding acceptability 299(56.1%) of the 533 prescribed oral medicines were not suitable to administer for their children according to the parents/caregivers. Overall solid dosage forms were found difficult to administer/unacceptable in 173(78.3%) the 221 children’s treated with either tablet/capsules.

Conclusions: The majority of the prescribed oral medicines were found not to be age-appropriate and unsuitable to administer despite age-appropriate options are available in the national essential medicine list and WHO list of medicines of children. Therefore, adopting the WHO EML for pediatric population in a way that reflects the ‘child size medicine concept’ and local needs is recommended to ensure age-appropriate, child and caregiver friendly dosage forms for young children.