At our last London YPAG meeting on the 6th of February, we had two researchers called Sara Hanning and Catherin Tuleu from the University College London School of Pharmacy come and talk with us about the rectal route of administering medicines. They are working on a project that is looking at administering antibiotics through the rectal route in children and young people in developing countries. They explained that tablets aren't always ideal as they require the child has the capacity to swallow, and this is not possible for babies. Liquid formulations are not necessarily ideal either as they require access to clean water and refrigeration, which is not always possible in developing countries. Sara and Catherine also explained that rectal formulations of medicines, called suppositories, are commonly available in European countries such as France and Spain, even for such common medicines as Paracetamol and Ibuprofen. As we know, this is not common in England. So, Sara and Catherine wanted to get an idea of to what extent children and young people in the UK are comfortable with the idea of medicine administered via the rectal route to inform a future study they will be doing and how the topic of rectal drug delivery could be broached with children and young people in a way they would feel comfortable.
To begin with, some of the YPAG members didn't realise that medicines could be administered through the rectal route, but when the anatomy of the digestive system was explained, the YPAG members felt this was logical. It was also enlightening to the group to learn that suppositories are commonly available in Europe. Overall the group felt that the rectal route of delivering medicines is acceptable, and would be especially so in developing countries where access to clean water can be inadequate. They felt that, where possible, the administration should be done by a trusted adult (such as a parent or doctor) but they worried that it would open up the potential, or opportunity, for sexual abuse of the child. They thought it was especially important that the child or young person him/herself would be able to self-administer the suppository, and that this responsibility might be appropriate when the child or young person starts developing more body awareness and takes on the responsibility of bathing him/herself.
Sara and Catherine were impressed by the feedback the group gave, and are now working with Erin and two YPAG members who expressed a particular interest in this opportunity to write up the feedback for publication. Publication of PPI activity is nascent, which is why we felt this is important and are happy to contribute. We'll post the article when it's published, so stay tuned for that.