Comparison of taste and texture of Metamucil®, Volcolon® and psylium orange generic (WC2016-037)

Background

Starting date: 01/11/2016

A pleasant taste of a prescription improves patient compliance and adherence. According to the literature, only 50% of patients who suffer from chronic diseases adhere to treatment recommendations1. This results in suboptimal outcomes2. There are numerous factors that affect adherence, including characteristics of the illness, interaction between physician and patient, the complexity and duration of treatment, side effects of treatment and costs of treatment3. Furthermore, medication palatability is also crucial for adherence. Several studies have addressed the palatability of medication for different disorders, like hypertension, HIV and Alzheimer’s disease4-6. Therefore, pharmaceutical companies pay attention to manufacture more formulations and add pleasant flavours which may improve the palatability.  

Fiber supplements are increasingly used for treatment of chronic constipation both in adults and children. In the Netherlands several formulas are available such as Metamucil orange®, Volcolon® and generic psyllium orange. These are effective and save formulas. Little literature is available concerning taste and laxatives or fibers, although many patients complain about taste and texture of the preparations.  Studies with polyethylene glycol preparations performed by our research group demonstrated some differences in palatability between these preparations7-9.  

There are hardly any studies about fibers and taste. The taste is mentioned to be acceptable; one study compares dried prunes with psyllium and concludes there is no difference in taste experience10. In order to improve patient compliance, it is of clinical importance to know which preparations are the most acceptable to the patient, and use that as first choice. We hypothese that the taste and palatability of Metamucil orange® is preferable.

Literature: 

1. World Health Organisation. Adherence to long term therapies: evidence for action.  2003.

2. Osterberg L, Blaschke T. Adherence to medication 1. N Engl J Med 2005 August 4;353(5):487-97.

3. Ingersoll KS, Cohen J. The impact of medication regimen factors on adherence to chronic treatment: a review of literature 1. J Behav Med 2008 June;31(3):213-24.

4. Van der Linden D, Callens S, Brichard B, Colebunders R. Pediatric HIV: new opportunities to treat children 1. Expert Opin Pharmacother 2009 August;10(11):1783-91.

5. Meier CM, Simonetti GD, Ghiglia S, Fossali E, Salice P, Limoni C et al. Palatability of angiotensin II antagonists among nephropathic children 1. Br J Clin Pharmacol 2007 May;63(5):628-31.

6. Yan YD, Woo JS, Kang JH, Yong CS, Choi HG. Preparation and evaluation of taste-masked donepezil hydrochloride orally disintegrating tablets 1. Biol Pharm Bull 2010;33(8):1364-70.

7. Felt-Bersma R.J., Kooyman G., Kuipers E.J. Colonic lavage prior to colonoscopy: comparable outcomes of two polyethylene-glycol preparations and a sodium-phosphate solution. Ned Tijdschr Geneeskd. 2004 Jan 24; 148 (4): 181-5

8. Szojda MM, Mulder CJ, Felt-Bersma RJ. Differences in taste between two polyethylene glycol preparations.J Gastrointestin Liver Dis. 2007;16(4):379-81

9. Lam TJ, Mulder CJ, Felt-Bersma RJ. Differences in taste between three polyethylene glycol preparations: a randomized double-blind study. Patient Prefer Adherence. 2011;5:423-6.

10. Attaluri A, Donahoe R, Valestin J, Brown K, Rao SS. Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation. Aliment Pharmacol Ther. 2011;33:822-8.