Exploration into the opinions of patients with HIV, healthcare professionals and the lay public of the use of microneedl
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ORIGINAL ARTICLE
Exploration into the opinions of patients with HIV, healthcare professionals and the lay public of the use of microneedles in clinical practice: highlighting the translational potential for their role in HIV infection Kurtis Moffatt 1 & Caoimhe Quinn 1 & Paul J. McCague 1 & Ryan F. Donnelly 1 Accepted: 28 August 2020 # The Author(s) 2020
Abstract Poor adherence to oral antiretroviral therapy (ART) remains an important challenge in the treatment of HIV. Microneedles (MN) potentially could offer a non-invasive long-acting (LA) delivery approach, avoiding the need for daily dosing of ART. However, this claim has yet to be explored amongst its potential end-users. The aim of this mixed methods study was to investigate the perspectives from various end-users surrounding the translation of MN technology to general clinical practice, with a particular focus on delivery of ART. Quantitative postal questionnaires were distributed amongst healthcare professionals (HCPs) and the lay public (LP). A total of 208 responses were obtained (HCP, 69; LP, 139), with a completion rate of 34.7%. The consensus on MN technology was positive from both demographics (HCP, 97.1%; LP, 98.6%), with further strong support of postulated MN use within HIV (HCP, 97.1%; LP, 98.6%). Qualitative focus groups were employed to investigate in-depth, the perspectives of 12 patients with HIV. Again, consensus on MN technology was positive, highlighting benefits pertinent to HIV, including discreet self-application and potential sustained release thus avoiding daily oral ART and associated side effects. Patient concerns focused on the need for varied MN dosing schedules and a reluctance to change from established ART. The findings of this study provide an initial indication of MN acceptability, particularly for use within HIV, from various end-user demographics. Furthermore, concerns raised advocate the importance of continued translational research in this area and should act as motivators for those in MN development to ensure a patient-centred MN product is delivered. Keywords Microneedles . HIV . Opinions . Healthcare professional . Lay public . Patient
Introduction HIV remains a global pandemic with 37.9 million people affected worldwide at the end of 2018. While advances in antiretroviral therapy (ART) treatment efficacy have significantly reduced HIV- and AIDS-related mortality and morbidity, HIV is still progressing at an alarming rate of 1.7 million new cases per annum [1]. Recently, sub-optimal adherence to oral multidrug ART as a result of high pill burden has emerged as the primary cause of treatment failure and development of drug-
* Ryan F. Donnelly [email protected] 1
School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
resistant virus [2]. Accordingly, substantial effort has been invested to reduce dosing frequencies to once-daily oral regimens, while co-formulation has reduced the daily number of pills by offering fixed-dosed combination (FDC) tablets. Nevertheless, treatment fatigue
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