Overall, 24 participants were approached at the SSSU, of whom 17 agreed to participate in the interview. Of the 7 who declined, 5 participants did not participate due to inconvenience and 2 participants did not disclose a reason for their lack of participation. Among the 17 eligible participants, there were 11 female and 6 male participants. The age of these participants ranged from 24–45 years, with the median age of 30 years. The indication for the participant’s child’s surgery was not recorded to maintain participant confidentiality. Finally, data saturation was observed by the 13th interview, but four more interviews were conducted to confirm data saturation.
Stage 1 Analysis: Data-Driven, Manifest Level
As identified in Table 1, commonly reported barries to oral medication among the paediatric population were bitter taste and artificial fruit flavour. On the contrary, a common facilitator among the paediatric population was taste masking the medication in various foods, such as ice-cream and fruit juice. Nonetheless, it appears the barriers and facilitators to oral medication among the paediatric population is centred around the palatability and appearance of the medication
Parents’ perspectives on oral medication among the paediatric population
Mask in food
(eg. Ice-cream, fruit juice)
Artificial fruit flavour
(‘Sometimes the taste is also too sweet. So she always has to take it with a drink.’)
Offer incentive to child
(eg. Chocolate, yoghurt)
(eg. Syrup medication)
Distract the child
(eg. Watch TV, play with iPad)
(eg. Round white pill)
(eg. Physical restraint)
As seen in Table 2, the participants who expressed positive attitudes towards the novel medication, commonly justified their position due to its positive utility in the preoperative setting. On the contrary, those expressing more negative views were concerned over the potential dangers associated with the proposed medication; psychologically and physiologically.
Parents’ perspectives on novel confectionary medication for the paediatric population
Utility for short-term use
Long-term psychological impact
(eg. Negative association with candy and medicine)
Education of child and parent regarding role of confectionary medication
(eg. Doctor, nurse or pharmacist explaining to child that this is a medicine)
Concerns over potential overdose administration at home
Stage 2 Analysis: Data-Driven, Latent Level
As seen with Tables 3 and 4, our latent-level analysis revealed two themes that underpinned parents’ perspectives on oral medication and medications that look like confectionary for the paediatric population: taste and medication safety. Specifically, these two themes appear to explain the potential reasons why parents have outlined certain barriers and facilitators to oral medication for their children and more importantly why they have undertaken a specific stance on novel medications that look like confectionary. Ultimately, these themes have highlighted the unique issues that regularly occur in the paediatric setting regarding medication administration.
Latent-level analysis: taste
Hiding in food, like cakes. My friend’s kid loves lamington, so she injected the medicine into lamington. It was syrup medicine and she put it in lamington. This helps to hide the bitter taste of the medicine. [P1]
With the antibiotic, the taste was the biggest issue. Even the orange flavour of antibiotic was not helpful. My child was too young (18 months) to complain of a particular taste. However, I think bitterness and chemically/weird flavour makes it too hard. [P3]
If the kid has to take it, anything that makes it easier for them. Less stress for me and for them. Also it’s better for them because if they need then they can take their medicine easily. [P3]
Short-term use before an operation I would definitely be more than fine. But if you had to take it on a daily basis for a long period of time then I think that would potentially an issue…However if it’s anything longer than that, then you might have to think twice about that. But hey if it’s easy to administer and the kids are happy with that I think it should be fine. [P5]
Latent-level analysis: medication safety
Sometimes I think we should just view medicine as medicine. Yeah you’re getting it into them. But I’ll be thinking more of the psychological element of that. What are the long term effects of that when they’re adults? If we are not recognising and acknowledging this is medicine. If a child is always given medicine that looks like chocolate. Then what point then, will they acknowledge that this is medicine. [P1]
I suppose I don’t want him to get used to having sweet stuff all the time. However as long as he understands that its medicine and it’s not something he can have all the time then I’d be fine with him regularly. [P12]
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During the interviews with participants, the importance of taste was evident as their responses were universally centred around this theme. It appears that taste was both a barrier and a facilitator to participants, depending on how they manipulated the medication for their child. However, the negative impact of bitter taste was apparent as this specific flavour was repeatedly reported as a prominent barrier among most parents (Table 3).
The critical role of palatable medication was also seen with most participants despite their differing stances towards the proposed novel medication. Many participants identified the utility of the taste-masked medication that look like confectionary in the preoperative setting, as a familiar taste and appearance will help relax their child during the unfamiliar stage of their hospital stay (Table 3).
Medication safety was another theme that seemed to underlie the participants’ responses in the interview. It is important to note that the notion of ‘medication safety’ is multi-faceted as it includes preventing an event that may lead to patient harm associated with medication.16 Therefore, this concept extends beyond physical means as several participants were also concerned of the intangible dangers associated with taste-masked medications that look like confectionary, such as long-term psychological consequences seen with lack of patient understanding. These sentiments were reflected by several different participants throughout the interviews (Table 4).