The paucity of evidence-based data on formulation characteristics preferred by the children is known to limit the design of tailored paediatric dosage forms. The European Paediatric Translational Research Infrastructure (EPTRI) commissioned a study to evaluate children’s dosage forms perceived preferences in some European countries and explore the feasibility of using the young persons advisory groups (YPAGs) to involve children in formulation research. An online, age-adapted survey was developed and translated into six languages. The survey link was disseminated across seven European countries: Albania, Italy, the Netherlands, and Dutch-speaking part of Belgium, Romania, Spain, and the United Kingdom. Respondents’ (n = 1172) perceived preferences for oral dosage forms primarily differed based on age, health status, and experience. Conventional dosage forms, i.e., liquid (35%), tablets (19%), and capsules (14%), were the most selected. Liquid was widely selected by children less than 12 years and by those healthy and taking medicines rarely. Monolithic solid forms were mostly chosen by adolescents and by children with a chronic disease taking medicines frequently. There was a clear lack of familiarity with more novel dosage forms (e.g., orodispersible films and granules). Noteworthy, granules were not appreciated, particularly by adolescents (52.8%). To rationalise the creation of paediatric formulations, it is important to involve children as active stakeholders and to apply tools assessing children’s perspectives on medicines to inform acceptable dosage form development from the start.

The colour of a product plays an important role in consumer experiences, and in the context of pharmaceutical products, this could potentially affect a patient’s expectations, behaviours, and adherence. Several studies have been conducted on adults, but little is known about children’s opinions on colours of medicines and to what extent medicines’ colour affects their acceptability. To address this gap, a systematic search in PubMed, Scopus, MEDLINE, and Web of Science was conducted. Two authors independently screened the titles, abstracts, and references of all articles and selected studies conducted on children (0–18 years old), assessing children’s preferences or opinions about colour of oral dosage forms as either a primary or secondary objective or as an anecdotal record. A total of 989 publications were identified and, after screening, 18 publications were included in the review. Red and pink were the most liked colours and there appeared to be a relationship between the colour of a medicine and expected taste/flavour. The review also highlighted a scarcity of information, usually collected as an anecdotal record. Several gaps in the current knowledge were underlined, emphasizing the need of patient-centred studies to understand if the use of certain colours can improve or worsen the acceptability of a paediatric medicine. This will help inform pharmaceutical manufacturers and regulators on the role and need of colours in children’s medicines beyond quality purposes.

The correct use of medicine administration devices is pivotal for optimal drug therapy in children. Little is known about end users' perspectives on administration device use. Thus, the aim of this study was to conduct a survey to gain information and opinions from caregivers and children regarding the usability of paediatric medicine administration devices. A survey was conducted at a primary school in the United Kingdom in children aged 10-12 years and their caregivers. It focused on oral and respiratory devices and comprised two identical parts: 1) for the caregivers, 2) for the children with parental consent. Ethics approval (REC4612-016) was obtained. A total of 57 caregiver-child pairs accessed the survey and it was completed by parents only (n = 4), children only (n = 31) or jointly (n = 22). Most participants (65 %) had taken liquid dosage forms (e.g., syrups/suspensions) compared to solid dosage forms (34 %). Oral devices most frequently used were oral syringes (42 %), measuring spoons (22 %), and household spoons (18 %), with parents most frequently demonstrating device use to their children. Respiratory devices were used less frequently, and pressurised metered-dose inhalers with/without spacer (pMDIs) were the most commonly used devices (11/13). Instructions on use were provided by healthcare professionals to both caregivers and children. Generally, oral and respiratory devices were considered easy to use and instructions were clear. However, for both oral and respiratory devices, some suggestions for device improvement were provided by participants. Education/training by healthcare professionals and clear supplier instructions (e.g., pictograms) may be especially effective in ensuring that caregivers and children are able to use administration devices appropriately and receive sufficient information on their correct use.

For orally administered drugs, palatability is key in ensuring patient acceptability and treatment compliance. Therefore, understanding children’s taste sensitivity and preferences can support formulators in making paediatric medicines more acceptable. Presently, we explore if the application of computer-vision techniques to videos of children’s reaction to gustatory taste strips can provide an objective assessment of palatability. Children aged 4 to 11 years old tasted four different flavoured strips: no taste, bitter, sweet, and sour. Data was collected at home, under the supervision of a guardian, with responses recorded using the Aparito Atom app and smartphone camera. Participants scored each strip on a 5-point hedonic scale. Facial landmarks were identified in the videos, and quantitative measures, such as changes around the eyes, nose, and mouth, were extracted to train models to classify strip taste and score. We received 197 videos and 256 self-reported scores from 64 participants. The hedonic scale elicited expected results: children like sweetness, dislike bitterness and have varying opinions for sourness. The findings revealed the complexity and variability of facial reactions and highlighted specific measures, such as eyebrow and mouth corner elevations, as significant indicators of palatability. This study capturing children’s objective reactions to taste sensations holds promise in identifying palatable drug formulations and assessing patient acceptability of paediatric medicines. Moreover, collecting data in the home setting allows for natural behaviour, with minimal burden for participants.

Background: Colour plays an important role in shaping consumer experiences, and in the context of medicines, it may influence patients’ expectations, behaviours, and treatment adherence. There is limited research on how children respond to medicine colour, despite their increased sensitivity to sensory cues. A previous literature review indicated that colour may affect medicine acceptability in children but highlighted the need for further research. This cross-sectional study aimed to fill that gap by directly collecting children’s opinions on the colour of oral medicines through an online survey, targeting a diverse paediatric population across age, health status, and countries in Europe. Methods: The survey, developed by UCL School of Pharmacy UCL REC (ID 26765/001) and reviewed by experts of the European Young Persons Advisory Group Network (eYPAGnet), was translated into five languages and distributed via QR codes and anonymous links. Response collection occurred between September 2024 and April 2025. Participants included children aged 3 to 18, with parental assistance when needed and parental consent. Responses were analysed using the software R Studio. Results: Out of 669 people who accessed the survey, 382 completed it. For liquids, pink (23%), colourless (16.5%), and blue (15.2%) were most preferred. Reasons included appealing look and taste associations (e.g., strawberry for pink). For solids, white (29.1%), pink (18%), and blue (12.5%) led, with neutral appearance and berry-related flavours cited. Statistically significant gender and age differences in preferences emerged, while variations by health, or country were not always significant. Ratings for previously used medicines highlighted preference for purple, pink, and blue, while white and colourless received moderate scores. A statistically significant link between taste and colour emerged (ρ = 0.42, p- value 2.2 × 10 ⁻¹⁶ ), suggesting that the colour of a medicine may influence children’s anticipation of its taste and shape their overall expectations of the treatment experience. Conclusion: This study offers valuable insight into children’s preferences for medicine colour. Pink and blue were associated with sweet/flavourful tastes, while neutral colours were perceived as tasteless, particularly by participants aged 12–18 years. These findings can inform paediatric formulation strategies, particularly the selection and use of colouring agents, in alignment with current regulatory requirements when their inclusion is considered necessary.