Paediatric medicine issues and gaps from healthcare workers point of view: survey results and a narrative review from the global accelerator for paediatric formulations project

• Published in: Frontiers in pharmacology Vol. 14; p. 1200848
• Main Authors: Barbieri, Elisa, Minotti, Chiara, Cavagnis, Sara, Giaquinto, Carlo, Cappello, Bernadette, Penazzato, Martina, Lallemant, Marc
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 17.07.2023
• Subjects: children; essential medicines; medicine access; paediatric formulation; Pharmacology; survey; survey; essential medicines; paediatric formulation; medicine access; children
• ISSN: 1663-9812; 1663-9812
• DOI: 10.3389/fphar.2023.1200848

The WHO Model List of Essential Medicines for Children (EMLc) has not been systematically revised in the last few years. We conducted a survey addressed to healthcare professionals prescribing, preparing, or administering medicines to children and a narrative review to identify problematic paediatric formulations or missing medicines in all therapeutic fields to inform the review of the EMLc in 2023. A total of 285 physicians (63%), 28 nurses (6%) and 142 pharmacists (31%), mostly working in the hospital setting, reported at least one problematic medicine. 290 medicines were reported as missing (completely or the child-appropriate formulation). The top three most mentioned were ciprofloxacin together with phenobarbital and omeprazole. 387 medicines were reported as problematic (34% were oral liquid formulations, 34% tablets, 18% parenteral preparations. Mostly of the products were antibacterials (27%), cardiovascular medicines (11%) and antivirals (11%). The obtained responses show the perspective of healthcare workers working around the world, particularly in the European region (25%), in the African region (24%), and in the Region of the Americas (19%), with limited representation from Northern Africa and the Middle East. Our results need to be analysed with the outputs of other ongoing works before specific products can enter the WHO-hosted Global Accelerator for Paediatric formulations network prioritisation process. Efforts to develop appropriate formulations for children should be accelerated so that the uncertainties associated with off-label drug preparation and use are minimised, and therapeutic benefits are optimised.