• Ascorbyl palmitate/DSPE-PEG nanocarriers for oral iron delivery: preparation, characterisation and in vitro evaluation

      Zariwala, Mohammed Gulrez; Farnaud, Sébastien; Merchant, Zahra; Somavarapu, Satyanarayana; Renshaw, Derek; University of Westminster; University of Bedfordshire; UCL School of Pharmacy (Elsevier, 2014-03-01)
      The objective of this study was to encapsulate iron in nanocarriers formulated with ascorbyl palmitate and 1,2-distearoyl-sn-glycero-3-phosphoethanolamine polyethylene glycol (DSPE-PEG) for oral delivery. Blank and iron (Fe) loaded nanocarriers were prepared by a modified thin film method using ascorbyl palmitate and DSPE-PEG. Surface charge of the nanocarriers was modified by the inclusion of chitosan (CHI) during the formulation process. Blank and iron loaded ascorbyl palmitate/DSPE nanocarriers were visualised by transmission electron microscopy (TEM) and physiochemical characterisations of the nanocarriers carried out to determine the mean particle size and zeta potential. Inclusion of chitosan imparted a net positive charge on the nanocarrier surface and also led to an increase in mean particle size. Iron entrapment in ascorbyl palmitate-Fe and ascorbyl palmitate-CHI-Fe nanocarriers was 67% and 76% respectively, suggesting a beneficial effect of chitosan on nanocarrier Fe entrapment. Iron absorption was estimated by measuring Caco-2 cell ferritin formation using ferrous sulphate as a reference standard. Iron absorption from ascorbyl palmitate-Fe (592.17±21.12 ng/mg cell protein) and ascorbyl palmitate-CHI-Fe (800.12±47.6 ng/mg, cell protein) nanocarriers was 1.35-fold and 1.5-fold higher than that from free ferrous sulphate, respectively (505.74±23.73 ng/mg cell protein) (n=6, p<0.05). This study demonstrates for the first time preparation and characterisation of iron loaded ascorbyl palmitate/DSPE PEG nanocarriers, and that engineering of the nanocarriers with chitosan leads to a significant augmentation of iron absorption.
    • Personalised adherence support for maintenance treatment of inflammatory bowel disease: a tailored digital intervention to change adherence-related beliefs and barriers

      Chapman, Sarah; Sibelli, Alice; St-Clair Jones, Anja; Forbes, Alastair; Chater, Angel M.; Horne, Robert; UCL School of Pharmacy; University of Bath; King’s College London; Brighton and Sussex University Hospitals NHS Trust; et al. (Oxford University Press, 2020-05-07)
      Background and aims: Interventions to improve adherence to medication may be more effective if tailored to the individual, addressing adherence-related beliefs about treatment and overcoming practical barriers to daily use. We evaluated whether an algorithm tailoring support to address perceptual and practical barriers to adherence reduced barriers and was acceptable to patients with IBD. Methods: Participants with IBD, prescribed azathioprine and/or mesalazine were recruited via patient groups, social media and hospital clinics and allocated to Intervention or Control Groups. The online intervention comprised messages tailored to address beliefs about IBD and maintenance treatment and provide advice on overcoming practical difficulties with taking regular medication. The content was personalised to address specific perceptual and practical barriers identified by a pre-screening tool. Validated questionnaires assessed barriers to adherence and related secondary outcomes at baseline, one and three months of follow-up. Results: 329 participants were allocated to the Intervention (n=153) and Control (n=176) Groups; just under half (46.2%) completed follow-up. At one and three months the Intervention Group had significantly fewer concerns about IBD medication (p≤.01); and, at three months only, fewer doubts about treatment need, fewer reported practical barriers and lower nonadherence (p<.05). Relative to controls at follow-up, the Intervention Group were more satisfied with information about IBD medicines, and viewed pharmaceuticals in general more positively. Questionnaires, interviews and intervention usage indicated the intervention was acceptable. Conclusions: Personalised adherence support using a digital algorithm can help patients overcome perceptual (doubts about treatment necessity and medication concerns) and practical barriers to adherence.