Assessing user preferences for design characteristics of oral dissolvable strips for pediatric HIV medication: a qualitative study

BMC Health Services Research

Research

Sarah Finocchario-Kessler¹  Catherine Wexler¹  Harshdeep Acharya¹  Nicodemus Maosa²  May Maloba²  Shadrack Babu²  Zachary Nicolay³  Edward Maliski³  Gregory Thomas⁴  Michala Sliefert⁵  George Mugendi⁶  Frederick Were⁶  Yvonne Mbithi⁶ 

[1] Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, USA;Global Health Innovations, Nairobi, Kenya;Oak Therapeutics, Lawrence, KS, USA;School of Architecture and Design, University of Kansas, Lawrence, KS, USA;School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA;University of Nairobi, Nairobi, Kenya;

关键词: HIV;    Pediatric antiretroviral therapy;    Antiretroviral therapy adherence;    Kenya;    Qualitative research;    User-centered design;   

DOI  :  10.1186/s12913-023-10078-6

 received in 2023-02-20, accepted in 2023-09-27,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundCurrent infant antiretroviral therapy formulations pose barriers to daily adherence due to complex weight-based dosing, conspicuous preparation, and poor palatability. These adherence barriers jeopardize adherence, making patients vulnerable to virologic failure, development of drug resistance, and preventable mortality. Our team has previously established proof-of-principle for multi-drug oral dissolvable strips as alternative pediatric antiretroviral formulations with the potential to overcome these challenges and improve pediatric ART adherence and outcomes. The objective of this study was to assess caregiver and provider preferences for oral dissolvable strips and its packaging to inform its development.MethodsGuided by concepts of user-centered design, we conducted key informant interviews with 30 HIV care providers and focus group discussions targeting caregivers of children < 10 years of age living with HIV at 3 Kenyan hospitals. Key informant interviews and focus group discussions were audio recorded, translated/transcribed verbatim, and hand coded for a-priori and emergent themes.ResultsA total of 30 providers and 72 caregivers (caring for 83 children, aged 5 months to 18 years) participated in the study. Caregivers and providers expressed a strong desire for an easier way to administer medication, especially among children too young to swallow tablets whole, and expressed enthusiasm around the idea of oral dissolvable strips. Key preferences included a pleasant taste; one strip per dose; small size with rapid dissolution; clear markings and instructions; and no special storage requirements. For packaging, stakeholders preferred individually wrapped strips within a dispenser. The individual packaging should be durable, waterproof, and easy to dispose of in communal spaces. They should also be easy to open, with clear indications where to open. The packaging holding the strips should be durable, re-usable, accommodating of various refill frequencies, and easy to use for children as young as 6.DiscussionThe concept of oral dissolvable strips was highly acceptable to caregivers of children living with HIV and HIV care providers. By engaging stakeholders in an iterative design process starting from the early phases of design and development, we will maximize the likelihood of developing a product that is acceptable to the caregiver and infant, therefore leading to sustainable adherence.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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