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In an innovative move aimed at enhancing patient care and reducing healthcare costs, the NHS is considering the prescription of tablets for children as young as four, particularly those diagnosed with congenital hyperinsulinism (CHI). Research from Great Ormond Street Hospital (GOSH) indicates that switching from liquid medication to tablets could save the NHS an impressive £40,000 per patient annually, while also improving the quality of life for young patients.
Transitioning from Liquid to Tablet Medications
The findings from GOSH’s recent study highlight a significant shift in the management of CHI, a rare condition that affects approximately one in 30,000 to 40,000 children. Traditionally, the primary treatment, diazoxide, has been administered in liquid form, costing £15.50 for a 50mg dose. However, the newly explored tablet formulation, priced at just £1.15 for the same dosage, presents a compelling financial alternative for the healthcare system.
The research involved 19 patients aged between seven and 13, all of whom were monitored closely to ensure their blood glucose levels remained stable throughout the transition. The results demonstrated not only the feasibility of the switch but also a marked preference among the children for tablets over their liquid counterparts, which are often challenging to consume due to their unpleasant taste.
Positive Feedback from Young Patients
Jess Manktelow, an 11-year-old patient at GOSH who has lived with CHI since she was 15 months old, shared her personal experience of the switch. Previously reliant on liquid diazoxide, Jess expressed relief at being able to take tablets: “It has made a big difference taking medicine that doesn’t taste horrible,” she noted. The switch has allowed her greater independence and reduced the time spent managing her condition, enabling her to engage in activities she enjoys, such as climbing.
Her mother, Steph Manktelow, echoed this sentiment, highlighting the relief and excitement they felt at the prospect of switching to tablets. “We’d been hoping for some time; we knew it was a better solution and would allow Jess to have control over her condition, and that is very important,” she remarked.
Future Assessments and Broader Implications
Following these promising results, GOSH researchers are planning additional studies to assess the viability of tablets for even younger patients, starting from age four. This initiative not only aims to enhance the physical health of young patients but also seeks to alleviate the emotional and social burdens associated with chronic illnesses.
Kate Morgan, a clinical nurse specialist at GOSH and co-lead of the project, emphasised the unexpected qualitative improvements in the children’s lives. “Children are so much more than their diagnoses. They have full lives and families, and their illnesses affect everyone, so it is very important we do all we can to make simple, positive changes that impact everyone for the better,” she stated.
Dr Antonia Dastamani, a consultant in paediatric endocrinology and diabetes at GOSH, highlighted the need for healthcare providers to consider patient preferences, particularly regarding medication. “This has shed light on key questions we now want to ask children and young people about their care and treatment so they can be more involved and have more independence in their lives,” she said.
Why it Matters
This shift towards tablet prescriptions for young patients with CHI represents a significant advancement in paediatric healthcare, merging cost-saving strategies with improved patient experiences. By addressing the dual priorities of financial efficiency and patient satisfaction, the NHS not only stands to alleviate its financial burdens but also to foster a healthcare environment that prioritises the voices and preferences of children. Such initiatives could set a precedent for future treatment protocols, ensuring that young patients receive care that is both effective and respectful of their individual needs.
