Abstract
Oral drug administration provided as solid oral dosage forms (SODF) remains the major route of drug therapy in primary and secondary care. There is clear evidence for a growing number of clinically relevant swallowing issues (e.g., dysphagia) in the older patient population, especially when considering the multimorbid, frail, and polymedicated patients. Swallowing impairments have a negative impact on SODF administration, which leads to poor adherence and inappropriate alterations (e.g., crushing, splitting). Different strategies have been proposed over the years in order to enhance the swallowing experience with SODF, by using conventional administration techniques or applying swallowing aids and devices. Nevertheless, new formulation designs must be considered by implementing a patient centric approach in order to efficiently improve SODF administration by older patient populations. Together with appropriate SODF size reductions, innovative film coating materials that can be applied to SODF and provide swallowing safety and efficacy with little effort being required by the patients are still needed. With that in mind, a literature review was conducted in order to identify the availability of patient centric coating materials claiming to shorten esophageal transit times and improve the overall SODF swallowing experience for older patients. The majority of coating technologies were identified in patent applications, and they mainly included well-known water soluble polymers that are commonly applied into pharmaceutical coatings. Nevertheless, scientific evidence demonstrating the benefits of given SODF coating materials in the concerned patient populations are still very limited. Consequently, the availability for safe, effective, and clinically proven solutions to address the increasing prevalence of swallowing issues in the older patient population is still limited.
Highlights
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.license.The improvements in modern healthcare provision, combined with the availability of new effective drug therapies, are both contributing to a continuous increase in average life expectancy [1]
Food aids with semi-solid consistency such as oral jellies, are commonly applied as an administration vehicle by older patients, because their rheological properties allow for an administration by older patients,the because allow for the formation of a vehicle bolus that incorporates
Data is only reported for young patients, the product is recommended to people of all ages that struggle with solid oral dosage forms (SODF)
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Ageing is associated with an increasing incidence of chronic diseases and co-morbidities, which leads to the practice of polypharmacy amongst the majority of the older patients [2] This topic raises safety concerns, as it was previously reported that a least. This literature review provides an overview on physical characteristics of older patients that can impact the administration and acceptability of drug therapies that are provided in SODF, including their relation to specific SODF designs. The importance of using a patient centric drug product design approach when developing appropriate SODF for the older patient population is discussed, being supported by a literature review on the film coating materials designed to enhance the swallowing experience and acceptability of SODF for older patients with impaired swallowing functions, including their clinical evidence for improved efficacy and safety
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