ADAPTA: ADAPTED ORAL DRUG FORMULATIONS FOR PREANESTHETIC USE IN CHILDREN WITH AUTISM SPECTRUM DISORDER
Pdf
European Statement
Production and Compounding
Author(s)
Carlota Mestres Gonzalvo
Juan José Lázaro Alcay
Ángela Pieras López
Marta Duero Adrados
Carlos Javier Moreno Pérez
Why was it done?
Children with ASD frequently reject standard oral medications due to sensory sensitivities, which increases distress and drives the use of invasive routes (intramuscular and/or intravenous), undermining safety, family wellbeing, and perioperative efficiency. Current forms are not adapted to ASD needs; the aim is to maximise acceptability and minimise distress through patient-friendly formulations and calming environments, ensuring equitable, high‑quality preanesthetic care.
What was done?
The project is creating and preparing to clinically evaluate novel, palatable oral formulations—such as sensory-friendly gummies—co-designed by hospital pharmacists, anaesthesiologists, and university formulation experts using advanced flavour–texture modification. In parallel, dedicated sensorial rooms with direct street-access entry, adjustable lighting and sound, and tactile comfort features are being incorporated to reduce overstimulation during preanesthetic preparation.
How was it done?
The first phase addresses obstacles such as heterogeneity in ASD sensory profiles and stringent pharmaco-technical and safety requirements. The team is overcoming these through stakeholder engagement with families, sensory mapping, iterative prototyping with in‑house stability and sensory testing, and multidisciplinary collaboration for rapid, compliant development. Hospital infrastructure supports integration, regulatory documentation, and implementation of sensorial rooms and staff training.
What has been achieved?
A multidisciplinary team has been established, equipment and consumables planned, and formulation development initiated, alongside design parameters for sensorial rooms and workflow integration. Expected outcomes include improved medication acceptance, reduced preanesthetic distress, fewer invasive interventions, greater perioperative efficiency, and higher staff confidence in ASD care, with internal dissemination and readiness for pilot evaluation.
What next?
The ADAPTA initiative is developing tailored oral drug formulations and implementing sensorial rooms to improve preanesthetic care for children with autism spectrum disorder (ASD), integrating pharmaceutical innovation with patient-centre ed strategies in a multidisciplinary hospital setting.
ADAPTA represents good practice by uniting pharmaceutical innovation with environmental and behavioural adaptations, offering a scalable, replicable model for inclusive paediatric anaesthesia. Next steps include completing prototype validation, pilot clinical and sensory acceptability studies within sensorial rooms, standardising operating procedures, and preparing for scale‑up across additional services and paediatric populations.
PATIENT-CENTRED CLINICAL PHARMACY AND MEDICINES INFORMATION SERVICE ON A PSYCHIATRIC INTENSIVE CARE UNIT
Pdf
European Statement
Clinical Pharmacy Services
Author(s)
Caroline Hynes, Dolores Keating
Why was it done?
Psychiatric intensive care is for patients who are in an acutely disturbed phase of a serious mental disorder. Psychotropic medicines play a pivotal role in the treatment of these disorders which is why the pharmacist is a key part of the patient care team. The introduction of a designated pharmacist to address not only the clinical needs of the PICU team but also the medicines information needs of the patient was essential to optimise patient outcomes.
What was done?
A liaison pharmacist was assigned to the psychiatric intensive care unit (PICU) to provide both a clinical pharmacy service including regular medication chart review and development of patient-centred clinical guidelines, and to provide medicines information and support directly to patients.
How was it done?
The main obstacle to the introduction of this initiative was establishing a relationship with patients, as visible pharmacist interventions were new to patients on the PICU. In order to overcome this obstacle, the pharmacist was required to be present on the unit and regularly meet patients to enquire about their experience of taking medicine for their mental health and provide information as required.
What has been achieved?
• The pharmacist hosts a weekly medicines information group on the unit where; medicines are discussed openly, patients are provided with medicines information leaflets and medicines charts detailing all of their current medicines and what they are for, and those taking antipsychotics are systematically assessed for side-effects
• The pharmacist carries out a regular clinical pharmacy review where medication charts are clinically assessed and any interventions are relayed to the relevant consultant psychiatrist and registrar
• The pharmacist develops new patient-centred guidelines for use on the PICU e.g. Guidelines on the pharmacological prevention and management of violence or aggressive behaviour
What next?
By having an awareness of the patient experience of their medicine (especially side-effects) through regular contact at the medicines information groups, the pharmacist is in a position to provide more informed clinical advice to the PICU team. This patient-centred approach to the clinical pharmacy service could be transferred to any healthcare setting where the pharmacist can link directly with both patients and their multidisciplinary team.