Evidence map›Paper›PMID 37845699›Full record

ArticleBMC health services research2023

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

Catherine Wexler, May Maloba, Michala Sliefert, Shadrack Babu, Nicodemus Maosa, Edward Maliski, Zachary Nicolay, Frederick Were, Yvonne Mbithi, George Mugendi and 3 more

Open access · goldAbstract read
In one paragraph

Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 47% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 3 countries.

Catherine WexlerDepartment of Family Medicine, University of Kansas Medical Center, Kansas City, KS, USA. cwexler@kumc.edu.
May MalobaGlobal Health Innovations, Nairobi, Kenya.
Michala SliefertSchool of Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
Shadrack BabuGlobal Health Innovations, Nairobi, Kenya.
Nicodemus MaosaGlobal Health Innovations, Nairobi, Kenya.
Edward MaliskiOak Therapeutics, Lawrence, KS, USA.
Zachary NicolayOak Therapeutics, Lawrence, KS, USA.
Frederick WereUniversity of Nairobi, Nairobi, Kenya.
Yvonne MbithiUniversity of Nairobi, Nairobi, Kenya.
George MugendiUniversity of Nairobi, Nairobi, Kenya.
Gregory ThomasSchool of Architecture and Design, University of Kansas, Lawrence, KS, USA.
Harshdeep AcharyaDepartment of Family Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
Sarah Finocchario-KesslerDepartment of Family Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
University of Kansas Medical Center · USUniversity of Nairobi · KEWren Therapeutics (United Kingdom) · GBUniversity of Kansas · US

Funding

Evaluating the HITSystem to Improve PMTCT Retention and Maternal Viral Suppression in KenyaR01MH121245 · NIMH · UNIVERSITY OF KANSAS MEDICAL CENTER · PI KESSLER, SARAH FINOCCHARIO · 2020 to 2024
$3.5M
Assessing caregiver and child preferences for the development of novel pediatric antiretroviral therapy deliveryR21HD105534 · NICHD · UNIVERSITY OF KANSAS MEDICAL CENTER · PI KESSLER, SARAH FINOCCHARIO · 2021 to 2022
$426k
NICHD NIH HHS R21 HD105534NIMH NIH HHS R01 MH121245
6 · The paper itself

Abstract

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. DISCUSSION: The 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.

Indexed as

HIV InfectionsAnti-Retroviral AgentsCaregiversChildHumansInfantKenyaMedication AdherenceQualitative ResearchAnti-Retroviral AgentsAntiretroviral therapy adherenceHIVKenyaPediatric antiretroviral therapyQualitative researchUser-centered design

Identifiers

PMID37845699
PMCPMC10580521
OpenAlexW4387666615

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.