Palatability of micro-encapsulated iron pyrophosphate (Ferfer®)
Background: Iron deficiency is the leading cause of anemia globally and affects 20% of world adult population. The general practice for replacement of iron reserves is oral supplementation. However, the success of this strategy solely depends on drug adherence and compliance. Where many other factors contribute to compliance, the role of taste of the medicine can also not be neglected. The aim of this study is to evaluate the palatability of micro-encapsulated iron pyrophosphate (Ferfer) and compare its taste with previously taken other oral forms of iron supplements.
Methods: The study was conducted with 231 female participants of age more than 18 years. Participants had taken one sachet of micro-encapsulated iron pyrophosphate (Ferfer) for the purpose of taste. Questionnaire based on their previous experience of iron supplements and palatability of Ferfer was asked by participants based on 0-10 mm visual analogue scale and 5 point Likert scale evaluating responses at 0 minute, 5 minute, and at 10 minute. Data was analyzed by using SPSS version 23.
Results: The women previously taking some others oral form of iron supplementation scored their supplements, a mean taste score is 2.92±2.44 on the VAS. However, micro-encapsulated iron pyrophosphate (Ferfer) received a mean score of 7.66±1.32 immediately after taking it and a score of 7.96±1.37 after 5 minutes on the 0-10 mm VAS. 81.4% patients will recommend their doctors to prescribe FERFER to them in future.
Conclusions: Enhanced palatability of micro-encapsulated iron pyrophosphate sachets have resulted in increased compliance to the supplementation regimen among the participants.
Meroño T, Dauteuille C, Tetzlaff W, Martín M, Botta E, Lhomme M, et al. Oxidative stress, HDL functionality and effects of intravenous iron administration in women with iron deficiency anemia. Clin Nutr. 2017;36(2):552-8.
National Heart Lung and Blood Institute (US). Iron Deficiency Anemia. U S Department of Health and Human Services, National Institutes of Health;. Available from: https://www.nhlbi.nih.gov/health-topics/iron-deficiency-anemia. Accessed on 19 January 2018.
World Health Organization. Global nutrition targets 2025: policy brief series. 2014. Available from: http://www.who.int/nutrition/publications/globaltargets2025_policybrief_overview/en/. Accessed on 19 January 2018.
Balarajan Y, Ramakrishnan U, Özaltin E, Shankar AH, Subramanian SV. Anaemia in low-income and middle income countries. Lancet. 2012;378(9809):2123-35.
Habib MA, Raynes-Greenow C, Soofi SB, Ali N, Nausheen S, Ahmed I, et al. Prevalence and determinants of iron deficiency anemia among non-pregnant women of reproductive age in Pakistan. Asia Pac J Clin Nutr. 2018;27(1):195.
Akhtar S, Ahmed A, Ahmad A, Ali Z, Riaz M, Ismail T. Iron status of the Pakistani population-current issues and strategies. Asia Pac J Clin Nutr. 2013;22(3):340-7.
National Institute of Population Studies (NIPS) [Pakistan] and ICF International. Pakistan demographic and health survey 2012-13. Demographic and Health Surveys. Islamabad, Pakistan, and Calverton, Maryland, USA: NIPS and ICF International; 2013.
Lone FW, Qureshi RN, Emanuel F. Maternal anaemia and its impact on perinatal outcome. Trop Med Int Health. 2004;9:486-90.
Galloway R, McGuire J. Determinants of compliance with iron supplementation: supplies, side effects, or psychology? Soc Sci Med. 1994;39(3):381-90.
Lutsey PL, Dawe D, Villate E, Valencia S, Lopez O. Iron supplementation compliance among pregnant women in Bicol, Philippines. Public Health Nutr. 2008;(1):76-82.
Tolkien Z, Stecher L, Mender AP, Pereira DI, Powell JJ. Ferrous sulphate supplementation causes significant gastrointestinal side-effects in adults: a systematic review and meta-analysis. PLoS ONE. 2014;10:e0117383.
Kouchak M, Ramezani Z, Bagheri F. Preparation and Evaluation of Taste Masking Iron Suspension: Taking Advantage of Weak Cationic Exchange Resin. AAPS Pharm Sci Tech. 2017;1:1.
Physiopedia. Visual Analogue Scale. Available at: https://www.physio-pedia.com/Visual_Analogue_ Scale. Accessed on 3 December 2017.
Talam NC, Gatongi P, Rotich J, Kimaiyo S. Factors affecting antiretroviral drug adherence among HIV/AIDS adult patients attending HIV/AIDS clinic at Moi Teaching and Referral Hospital, Eldoret, Kenya. East Afr J Public Health. 2008;5(2):74-8.
Baguley D, Lim E, Bevan A, Pallet A, Faust SN. Prescribing for children–taste and palatability affect adherence to antibiotics: a review. Arch Dis Child. 2012;97(3):293-7.
Mora JO. Iron supplementation: overcoming technical and practical barriers. J Nutr. 2002;132(4):853-5.
Camaschella C. Iron-deficiency anemia. N Engl J Med. 2015;372(19):1832-43.
Xiong X, Buekens P, Alexander S, Demianczuk N, Wollast E. Anemia during pregnancy and birth outcome: a meta-analysis. Am J Perinatol. 2000;17(3):137-46.
East P, Delker E, Lozoff B, Delva J, Castillo M, Gahagan S. Associations among infant iron deficiency, childhood emotion and attention regulation, and adolescent problem behaviors. Child Dev. 2017.
Zlotkin S, Arthur P, Antwi KY, Yeung G. Treatment of anemia with microencapsulated ferrous fumarate plus ascorbic acid supplied as sprinkles to complementary (weaning) foods–. Am J Clin Nutr. 2001;74(6):791-5.
Saha L, Pandhi P, Gopalan S, Malhotra S, kumar Saha P. Comparison of efficacy, tolerability, and cost of iron polymaltose complex with ferrous sulphate in the treatment of iron deficiency anemia in pregnant women. Med Gen Med. 2007;9(1):1.
Revankar VM, Garg A, Revankar MG. Efficacy of sodium feredetate versus ferrous sulfate in iron deficiency anemia in preganant women. Int J Reprod Contracept Obstet Gynecol. 2017;6(5):1978-81.