Perspectives on Using Fast-Dissolving Paracetamol for Mild-to-Moderate Pain Management in Elderly or Diabetic Patients with Delayed Gastric Emptying Rates: An Exploratory Study

Figures & data

Figure 1 Schematic of the discussion flow and review of evidence.

Table 1 Characteristics of General Practitioners (GPs) and Endocrinologists

General Practitioners (GPs)
	Australia (n=2)		Colombia (n=2)		Malaysia (n=2)		Saudi Arabia (n=2)		Sweden (n=2)
Years of practice	44	22	25	10	25	15	11	10	20	17
Practice setting (Clinic)	Private	Private	Private	Public	Private	Private	Private	Private	Private	Private
Proportion of time in direct patient care (%)	90	95	100	68	100	100	100	100	100	99
Number of patients seen in a month	1000	600	150	75	2000	1000	800	800	150	300
Number of patients suffering from mild-to-moderate pain, such as headaches	200	120	130	65–70	400	200	560	640	50	200
Proportion of patients of the following demographics (%)
Aged ≥60 years	50	70	60	70	30	30	60–70	50	90	65
Aged ≥60 years with diabetes	5	20	5	18	15	10	60–70	40	10	15
Treated with paracetamol	100	50	40	60–70	30	30	80–90	60–70	50	100

Table 2 Characteristics of Endocrinologists

Endocrinologists
	Australia (n=1)	India (n=1)	Malaysia (n=2)
Years of practice	22	20	20	10
Practice setting	Private clinic	Private hospital	Private hospital	Public/government hospital
Proportion of time in direct patient care (%)	95	95	100	100
Number of diabetic patients seen in a month	320	500	300	400
Number of patients suffering from mild-to-moderate pain, such as headaches	60	250	100	40
Proportion of patients treated with paracetamol (%)	80	70	>30	50

Table 3 General Practitioners’ (GPs) (n=10) Rating on Credibility, Clarity, and Impact of Evidence in the Study, the Rating Scale Used Was 1 to 5, with 1= Poor and 5= Excellent

	Australia (n=2)		Malaysia (n=2)		Saudi Arabia (n=2)		Colombia (n=2)		Sweden (n=2)
Physicians rating on evidence about FD-APAP’s rapid onset of action and its advantages compared to standard APAP.
Credibility	Neutral	Fair	Good	Good	Excellent	Good	Good	Good	Fair	Excellent
Clarity	Fair	Good	Excellent	Fair	Fair	Excellent	Excellent	Excellent	Fair	Excellent
Impact	Good	Good	Good	Good	Excellent	Excellent	Excellent	Good	Fair	Excellent
Physicians rating on evidence shared to demonstrate that “FD-APAP dissolves/disintegrates faster.”
Credibility	Excellent	Good	Excellent	Good	Excellent	Excellent	Excellent	Excellent	Good	Excellent
Clarity	Good	Good	Excellent	Excellent	Fair	Excellent	Excellent	Good	Good	Excellent
Impact	Good	Fair	Excellent	Good	Excellent	Excellent	Excellent	Excellent	Fair	Excellent
Physicians rating on evidence shared to demonstrate that “FD-APAP has faster absorption.”
Credibility	Excellent	Good	Good	Good	Excellent	Excellent	Excellent	Excellent	Good	Excellent
Clarity	Good	Good	Excellent	Excellent	Good	Excellent	Excellent	Excellent	Good	Excellent
Impact	Excellent	Good	Excellent	Good	Excellent	Excellent	Excellent	Excellent	Fair	Excellent
Physicians rating on evidence shared to demonstrate that “FD-APAP has better bioavailability.”
Credibility	Excellent	Good	Good	Good	Excellent	Excellent	Excellent	Excellent	Fair	Excellent
Clarity	Excellent	Good	Excellent	Excellent	Good	Excellent	Excellent	Excellent	Good	Excellent
Impact	Excellent	Good	Excellent	Good	Excellent	Excellent	Excellent	Excellent	Good	Excellent
Physicians rating on evidence about FD-APAP’s relevance among the diabetic population
Credibility	Fair	Fair	Good	Good	Excellent	Excellent	Excellent	Excellent	Neutral	Excellent
Clarity	Neutral	Neutral	Excellent	Good	Good	Excellent	Good	Excellent	Good	Excellent
Impact	Neutral	Good	Excellent	Excellent	Good	Fair	Excellent	Excellent	Neutral	Excellent

Figure 2 Consensus among GPs pertaining to the relevance of FD-APAP for pain management in the elderly and diabetic patient populations based on the feedback of their peers. Collective feedback from GPs for pain management in (A) elderly patients towards FD-APAP evidence credibility and impact, suitability of FD-APAP as a better alternative to NSAIDs, and key advantages of FD-APAP pertained to the faster disintegration and absorption of FD-APAP technology (OPTIZORB®) and (B) diabetic patients in terms of the relevance of FD-APAP and being able to address the need in patients with slower gastric emptying rate or GI changes, and the need to consider the complications or comorbidities associated with diabetes, while at the same time having minimal complications.

Table 4 Endocrinologists’ Rating on the Credibility, Clarity and Impact of the Evidence Shared for the Following Statements

	Australia (n=1)	India (n=1)	Malaysia (n=2)
Physicians rating on evidence about FD-APAP’s rapid onset of action and its advantages compared to standard APAP.
Credibility	Good	Excellent	Neutral	Good
Clarity	Good	Excellent	Good	Good
Impact	Good	Excellent	Good	Good
Physicians rating on evidence shared to demonstrate that “FD-APAP dissolves/disintegrates faster.”
Credibility	Good	Excellent	Good	Good
Clarity	Good	Excellent	Good	Neutral
Impact	Good	Excellent	Good	Good
Physicians rating on evidence shared to demonstrate that “FD-APAP has faster absorption.”
Credibility	Good	Excellent	Good	Good
Clarity	Good	Excellent	Good	Good
Impact	Good	Excellent	Good	Good

Figure 3 Consensus among endocrinologists pertaining to the relevance of FD-APAP for mild-to-moderate pain management in the diabetic patient population based on the feedback of their peers. Collective consensus on (A) the evidence on FD-APAP relevance in diabetic population is credible, believable, and impactful; key advantages of FD-APAP pertained to the faster disintegration and absorption of FD-APAP technology (OPTIZORB®) and (B) There is good confidence around the relevance of FD-APAP for mild-to-moderate pain management, and being able to address the slower gastric emptying rates or GI changes in diabetic patients.