MORE THAN A SPOONFUL OF SUGAR: UNDERSTANDING WHAT MAKES THE MEDICINE GO DOWN
Written By: Malissa Carroll, Web Content Specialist
Earlier this year, the Pediatric Pharmacy Advocacy Group (PPAG) at the School of Pharmacy partnered with FLAVORx – a private pharmaceutical company based in Columbia, Md., that supplies sugar-free, non-allergenic, and inert medicine flavorings and flavoring systems to pharmacies – to host its first-ever research competition focused on improving the palatability (flavoring) of medications for pediatric patients. The competition, which featured five teams of four student pharmacists presenting their original research projects to a panel of judges from both the School and FLAVORx, offered a great opportunity for faculty and students in attendance to not only learn about the teams’ ongoing research, but also the importance of medication palatability in the field of pediatric pharmacy.
Understanding The Struggle
When adults get sick, we understand that the medicines that our doctors prescribe will help us feel better — even if they don’t taste all that great. Children, on the other hand, haven’t yet learned that lesson, and can cause their parents a lot of undue stress as they fight to avoid ingesting those not-so-yummy-tasting formulations.
Surprised by the lack of research examining the effects of parental stress on medication administration in children, second-year student pharmacists Syra Jang, Ahrang Yoo, Christine Do, and Melissa Yuen, developed a project to explore the impact of medication flavoring on encouraging children to take their medications. Titled “Parental Stress and Coping Measures Related to Medication Administration in Children,” the project looked at the wide range of techniques that parents used to successfully administer medication to their children (e.g., flavoring, bribery, and other forms of positive and negative reinforcement), and whether those techniques helped to reduce stress for parents tasked with administering medicine to their children.
However, if a child is more likely to take a flavored medicine, shouldn’t the flavor be one that he or she enjoys? Wouldn’t a grape-flavored medication given to a child who prefers cherry-flavored medications be just as effective as giving him or her an unflavored medication? That was the question that another team of second-year student pharmacists sought to answer with their project titled “What Makes the Medicine Go Down?”
After discovering that not much was known about children’s preferences for medication flavor and taste, Alexandra Kirsh, Jordan Paavola, Arielle Pietron, and Kelly Murphy designed a research project that featured a short survey for parents and children ages 5-11 years. The survey contained questions about topics such as frequency of medication use, flavor preferences, color preferences, and preferred dosage form. Although the team found that parents could offer some insight into their children’s preferences, they concluded that children should still be included in the decision-making process when determining the flavor of their medicines.
Putting Knowledge into Practice
While there have been studies that examined the palatability of medications for children with short-term illnesses, another team of second- and third-year student pharmacists found that the same breadth of information does not exist for medications prescribed to children with long-term illnesses, such as mental health disorders.
With more children being prescribed medications for a variety of mental health conditions — including attention-deficit/hyperactivity disorder (ADHD), autism, and depression — team members Christine Nguyen, Wenye Yang, Ha Phan, and Dennisse Rubio set out to determine if the taste of liquid psychotropic medications might affect children’s adherence to those medications. Titled “Palatability of Medications Used for Mental Health Disorders,” the project examined how children viewed the liquid medications used to treat their mental health disorders and explored different methods to reduce parents’ stress when administering those medications.
Noticing the number of studies exploring how parents can encourage their children to take medications as prescribed, the remaining team of third-year student pharmacists decided to change the dialogue, asking about the role that health care professionals play in ensuring that parents are equipped with the tools and skills that they will need to administer medications to their children.
For their project titled “Comparing Medication Palatability and Flavoring Knowledge of Healthcare Professional Students,” team members Brandon Biggs, Elaine Pranski, David Tran, and Emily Chen surveyed pharmacy, medical, dental, and graduate nursing students in the final year of their programs and compared their medication palatability and flavoring knowledge, content lecture hours provided by their school curricula, and confidence in suggesting flavoring recommendations. Although most students reported receiving zero lecture hours dedicated to these subjects, the team found that graduate nursing and pharmacy students performed the best when asked to identify medications with favorable and unfavorable taste profiles and demonstrated the most confidence in their ability to make flavoring recommendations.
Making A Difference for Children
To the faculty and students who attended, the friendly research competition was an astounding success. Each team was able to set itself apart from the competition by not only identifying an existing gap in the field, but also developing an innovative research project to address that gap. Thrilled with the students’ creativity, the judges declared each team a winner in its own respect, noting the outstanding quality of the presentations delivered and commending students for their commitment to their research.