SP5 Children’s and families’ views of 3d-printed/personalised medicines in clinical practice

Background Children and young people are three times more likely than adults to experience harm from medicines.¹ 75–85% of patients suffer from unwanted side effects from therapy not based on individual requirements² resulting in 1 in 15 hospital admissions in the UK.³ Medication adherence is a significant concern in children due to unsuitable formulations and other factors.⁴

3D printing (3DP) is a novel approach of formulating personalised medicines using a pharmaceutical 3D printer. The technology allows ‘printing’ of tablets with personalised dose in customisable sizes, shapes, colours, textures and flavours and has the ability make a combination ‘all-in-one’ polypill to aid adherence. From a clinician’s point of view, there are clear potential advantages to this approach for making the formulation truly ‘personalised’ for safer, more accurate dosing, while minimising side effects from excipients and thereby improving patient concordance. Patient and public opinion will help identify the need for this technology and shape any study design with 3DP, including interpretation and dissemination of findings for publications.

Aim To obtain the views of children and their families about the concept of using 3D printing technology to produce personalised medicines for children.

Method An interactive stall was set up as part of a 1-day patient and public involvement and engagement (PPIE) event in a large paediatric tertiary hospital to engage hospital visitors and staff to gather their views and opinion on the 3D printing technology. A voting system with stickers were used to engage young people and adults to express their priorities. A section was provided for the participants to express their hopes and concerns about the technology. Sample 3D printed placebo tablets of various types (colours/shapes/sizes and polypills) were available for members of the public to experience their looks and feel. Children and families were also encouraged to design their ideal form of medicine by drawing. To educate participants about the technology, a poster wall was on display to walk participants on how these medicines are manufactured and a brief background of this technology. No ethical approval was needed as this was a public engagement activity, with the aim to inform future research.

Results A total of 61 individuals, comprised of children and their families engaged with our team to express their views on 3D printing. All 61 individuals expressed positive views and would be interested in having their medicines 3D printed. Participants had expressed opinion simultaneously on multiple aspects: Size of tablets was ranked most important for 6 participants (ranked 6/91 or 9.8%); shape for 9 (14.8%) participants; taste/flavour for 15 (24.6%) participants; colour for 10 (16.4%) participants; and a combination polypill was important for 11 (18%) participants.

Conclusion Children and their families showed great level of engagement with the researchers on the subject of 3D printed tablets. All individuals who engaged with the activity would prefer 3D printed tablets over conventional ones. 3D printed tablets for paediatrics is an under represented area of research with a good level of interest from the public.

References

1. Kaushal R, Bates DW, Landrigan C, et al. Medication errors and adverse drug events in pediatric inpatients. JAMA 2001;285:2114–2120.

2. Amekyeh H, Tarlochan F, Billa N. Practicality of 3D printed personalized medicines in therapeutics. Front Pharmacol 2021;12:646836.

3. Graham E. Improving outcomes through personalised medicine. NHS England MDM Diagnostics and Personalised Medicine Unit. 2016. Improving outcomes through personalised medicine (england.nhs.uk)

4. Ivanovska V, Rademaker C, Dijk L, et al. Pediatric drug formulations: a review of challenges and progress. Pediatrics 2014;134:361–372.