RESUMO
A cross sectional pan-India study about use of administration devices for paediatric oral and inhalation medicines was conducted with a diverse pool of participants of various age groups. Via 634 respondents from more than 15 states in India, this study has identified the administration devices commonly used by parents/caregivers for children 0 to 18 years and by children over 10 years. It has provided insights on device ease of use, challenges faced and recommendations to facilitate the correct use of administration devices for paediatric oral and inhalation medicines. Ethics approval (DPSRU-BREC/2020/A/008)) was obtained from the Biomedical Research Ethics Committee of Delhi Pharmaceutical Sciences and Research University. The survey was completed by parents only (n = 514) and jointly by both parents and children (n = 120). The mean age of the child was 7.2 ± 4.96 years. 72% of the respondents reported that an oral medicine had been taken recently, 6.3% reported that an inhaled medicine had been taken and the remaining 21.9% reported that both an oral and inhaled medicine had been taken. The use of measuring cup was most prevalent followed by household spoons. The mean of the score for ease of use was found to be highest 4.6 ± 0.50 for oral syringe and lowest (3.8 ± 0.76) for measuring cups. The majority of them found the oral device easy to use. Difficulties were reported mostly for measuring cups and household spoons and were related to a lack of user instructions and measuring difficulties. The respondents who found the device easy to use had mostly received clear instructions from healthcare professionals. Compared to oral devices, there were very limited responses for inhalation devices (n = 175/634). Nebulisers with facemasks were most frequently used followed by manually actuated Metered dose inhalers with and without spacer. The mean of the ease-of-use score for dry powder inhalers was found to be highest (4.2 ± 0.37) followed by mist inhalers (4.0 ± 0) and manually actuated pressurised metered dose inhalers (4.0 ± 0.71). The nebulisers with facemask were reported to be difficult to use by most of the respondents despite receiving clear instructions from healthcare professionals. The study findings add evidence to the understudied area of user experiences and perspectives on administration devices for oral and inhalation medicines in India. It highlights a need for initiatives to improve the usability, availability, and affordability of administration devices for children in India. Awareness on the importance of proper use of devices needs to be raised and sustained about the existence of affordable administration devices.
RESUMO
OBJECTIVES: Many reviews have been conducted on the economic evaluation of the HPV vaccine in global north countries. But there is a dearth of such reviews in the Global South countries. Hence, this systematic review aims to summarize studies done in these countries. METHODS: Four databases PubMed, Embase, Cochrane Library, and Google Scholar from 2009 to 2019 were searched for economic evaluations on HPV vaccination in the Global South countries. PRISMA guidelines were followed to include full-text articles. 40 original articles were shortlisted for full-text review. RESULTS: Studies had varied models, assumptions, and results according to different scenarios. Most studies concluded HPV vaccination to be cost-effective under varied scenarios and vaccine cost was the most influential parameter affecting the sensitivity analyses, consequently incremental cost-effectiveness ratio. A wide range in the cost-effectiveness ratio was observed in the included studies due to different study settings, populations, and inconsistencies in modeling practices (variations in methodological approaches). CONCLUSIONS: This review suggests the introduction of HPV vaccination alone or in combination with screening according to different countries. The price of the vaccine should be economical and funds for the vaccine should be provided by public sector firms.
