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Postgrad Med J 88:499-502 doi:10.1136/postgradmedj-2011-130306
  • Ethics and law

Inadvertent prescription of gelatin-containing oral medication: its acceptability to patients

Press Release
  1. Stephen Payne1
  1. 1Department of Urological Surgery, Manchester Royal Infirmary, Oxford Road, Manchester, UK
  2. 2Pharmacy Department, South-West Yorkshire Partnership NHS Foundation Trust, Fieldhead Hospital, Wakefield, UK
  1. Correspondence to Stephen Payne Consultant Urological Surgeon, Department of Urological Surgery, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK; stephen.payne{at}cmft.nhs.uk
  1. Contributors BV prepared the questionnaire, collected and collated the data and prepared the original manuscript. MP collected relevant pharmaceutical information and helped in editing the manuscript. SP was responsible for evolution of the study, editing of the questionnaire, reanalysis, and checking of the edited the manuscript and preparing it for submission. He was also responsible for modification of the manuscript after review and for all formatting changes required editorially.

  • Received 4 July 2011
  • Accepted 15 January 2012
  • Published Online First 28 February 2012

Abstract

When prescribing, doctors usually only consider the ‘active’ component of any drug's formulation ignoring the majority of the agents which make up the bulk of the tablet or capsule, collectively known as excipients. Many urological drugs contain the excipient gelatin which is, universally, of animal origin; this may conflict with the dietetic ideals of patients. A questionnaire-based study, undertaken between January and June 2010 in a mixed ethnicity inner-city population presenting with urological symptoms, asked which patients preferred not to ingest animal-based products, who would ask about the content of their prescribed treatment and who would refuse to take that medication if alternatives were available. Ultimately, the authors sought to find out how many patients had been inadvertently prescribed gelatin-containing oral medications and to suggest ways in which prescriptions might be more congruous with an individual patient's dietetic wishes. This study demonstrated that 43.2% of the study population would prefer not to take animal product-containing medication even if no alternative were available. 51% of men with lower urinary tract symptoms were also found to have inadvertently been prescribed gelatin-containing products against their preferred dietary restriction. Education of healthcare professionals about excipients and getting them to ask about a patient's dietetic preferences may help avoid inadvertent prescription of the excipient gelatin in oral medications. Substitution of gelatin with vegetable-based alternatives and clearer labelling on drug packaging are alternative strategies to help minimise the risks of inadvertently contravening a patient's dietetic beliefs when prescribing oral medication.

Footnotes

  • Data access: All authors had full access to all of the data (including statistical reports and tables) in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Competing interests None.

  • Patient consent Patient consent was not obtained but the presented data are anonymised and there is no risk of participant identification.

  • Provenance and peer review Not commissioned; externally peer reviewed.