Gluten in pharmaceutical products: a scoping review.
Celiac disease
Diet, gluten-free
Excipients
Gluten
Pharmaceutical preparations
Scoping review
Journal
Systematic reviews
ISSN: 2046-4053
Titre abrégé: Syst Rev
Pays: England
ID NLM: 101580575
Informations de publication
Date de publication:
07 08 2021
07 08 2021
Historique:
received:
30
10
2020
accepted:
21
07
2021
entrez:
8
8
2021
pubmed:
9
8
2021
medline:
24
8
2021
Statut:
epublish
Résumé
Celiac disease (CD) is one of the most common gluten-related disorders. Although the only effective treatment is a strict gluten-free diet, doubts remain as to whether healthcare professionals take this restriction into consideration when prescribing and dispensing medicines to susceptible patients. This scoping review aimed to find out the current evidence for initiatives that either describe the gluten content of medicines or intend to raise awareness about the risk of prescribing and dispensing gluten-containing medicines in patients with CD and other gluten-related disorders. A scoping review was conducted using three search strategies in PubMed/MEDLINE, TripDatabase and Web of Science in April 2021, following the PRISMA extension for scoping reviews (PRISMA-ScR). References from included articles were also examined. Two researchers screened the articles and results were classified according to their main characteristics and outcomes, which were grouped according to the PCC (Population, Concept and Context) framework. The initiatives described were classified into three targeted processes related to gluten-containing medicines: prescription, dispensation and both prescription and dispensation. We identified a total of 3146 records. After the elimination of duplicates, 3062 articles remained and ultimately 13 full texts were included in the narrative synthesis. Most studies were conducted in the US, followed by Canada and Australia, which each published one article. Most strategies were focused on increasing health professional's knowledge of gluten-containing/gluten-free medications (n = 8), which were basically based on database development from manufacturer data. A wide variability between countries on provided information and labelling of gluten-containing medicines was found. Initiatives regarding the presence of gluten in medicines, including, among others, support for prescribers, the definition of the role of pharmacists, and patients' adherence problems due to incomplete labelling of the medicines, have been continuously developed and adapted to the different needs of patients. However, information is still scarce, and some aspects have not yet been considered, such as effectiveness for the practical use of solutions to support healthcare professionals.
Sections du résumé
BACKGROUND
Celiac disease (CD) is one of the most common gluten-related disorders. Although the only effective treatment is a strict gluten-free diet, doubts remain as to whether healthcare professionals take this restriction into consideration when prescribing and dispensing medicines to susceptible patients. This scoping review aimed to find out the current evidence for initiatives that either describe the gluten content of medicines or intend to raise awareness about the risk of prescribing and dispensing gluten-containing medicines in patients with CD and other gluten-related disorders.
METHODS
A scoping review was conducted using three search strategies in PubMed/MEDLINE, TripDatabase and Web of Science in April 2021, following the PRISMA extension for scoping reviews (PRISMA-ScR). References from included articles were also examined. Two researchers screened the articles and results were classified according to their main characteristics and outcomes, which were grouped according to the PCC (Population, Concept and Context) framework. The initiatives described were classified into three targeted processes related to gluten-containing medicines: prescription, dispensation and both prescription and dispensation.
RESULTS
We identified a total of 3146 records. After the elimination of duplicates, 3062 articles remained and ultimately 13 full texts were included in the narrative synthesis. Most studies were conducted in the US, followed by Canada and Australia, which each published one article. Most strategies were focused on increasing health professional's knowledge of gluten-containing/gluten-free medications (n = 8), which were basically based on database development from manufacturer data. A wide variability between countries on provided information and labelling of gluten-containing medicines was found.
CONCLUSION
Initiatives regarding the presence of gluten in medicines, including, among others, support for prescribers, the definition of the role of pharmacists, and patients' adherence problems due to incomplete labelling of the medicines, have been continuously developed and adapted to the different needs of patients. However, information is still scarce, and some aspects have not yet been considered, such as effectiveness for the practical use of solutions to support healthcare professionals.
Identifiants
pubmed: 34364399
doi: 10.1186/s13643-021-01772-9
pii: 10.1186/s13643-021-01772-9
pmc: PMC8349483
doi:
Substances chimiques
Pharmaceutical Preparations
0
Glutens
8002-80-0
Types de publication
Journal Article
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
218Informations de copyright
© 2021. The Author(s).
Références
Lancet. 2018 Jan 6;391(10115):70-81
pubmed: 28760445
Can Med Assoc J. 1985 Jul 15;133(2):114-5
pubmed: 4005755
Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2
pubmed: 29551598
Dig Dis. 2015;33(2):141-146
pubmed: 25925915
J Am Pharm Assoc (2003). 2008 Sep-Oct;48(5):e125-35; quiz e136-9
pubmed: 18826893
Hosp Pharm. 2013 Oct;48(9):736-43
pubmed: 24421547
Med J Aust. 1987 Jan 19;146(2):91-3
pubmed: 3796428
Am J Health Syst Pharm. 2001 Mar 1;58(5):396-401
pubmed: 11258175
Am J Pharm Educ. 2018 Mar;82(2):6353
pubmed: 29606714
Pharmacoeconomics. 2019 Jan;37(1):45-61
pubmed: 30221333
Am J Health Syst Pharm. 2015 Jan 1;72(1):54-60
pubmed: 25511839
J Pain Symptom Manage. 2006 Mar;31(3):195-6
pubmed: 16563311
Int J Clin Pharm. 2016 Oct;38(5):1294-300
pubmed: 27503280
Gut. 2013 Jan;62(1):43-52
pubmed: 22345659
J Pediatr Gastroenterol Nutr. 1994 Jul;19(1):27-33
pubmed: 7965473
Dig Liver Dis. 2017 Feb;49(2):138-146
pubmed: 27887897
Ann Intern Med. 2018 Oct 2;169(7):467-473
pubmed: 30178033