Title:
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Microneedle technology for older people
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It is evident that the global population is ageing, with an increasing proportion of people aged over 65 years. Typically associated with a high proportion of morbidity and mortality, care of the increasing ageing population presents a challenge, with age-appropriate research required to promote and facilitate healthy ageing. In the present work, a novel drug delivery technology, designed to enhance transdermal drug delivery, was considered in the context of its potential future use in the older population.
Microneedles (MNs) consist of a plurality of tiny projections in the micron scale, arranged on a base plate, for application to the skin. This thesis considers the use of MNs by the older population from a number of perspectives, encompassing possible clinical uses, the possible impact of age-related changes in the skin and the feasibility and acceptability of the technology. Transdermal delivery of three drugs, commonly prescribed for secondary prevention of cardiovascular disease, was investigated, successfully demonstrating in vitro co-delivery of the drugs, using both a dissolving and a hydrogelforming MN platform, achieving clinically relevant concentrations of each. MN arrays were successfully applied by a group of volunteers aged over 65 years, with breach of the stratum corneum confirmed using optical coherence tomography and 55.7% of the MN height observed to penetrate. Skin recovery was demonstrated to occur at a slower rate in those aged over 65 years than in a comparative group of volunteers aged 20 - 30 years, but was still predicted to regain original barrier function within 1.5 h of MN treatment. Qualitative methods were employed to collect the views and opinions of older people and community pharmacists regarding MNs, who were positive about the technology, identifying a number of benefits to MN-mediated drug delivery in older people. Concerns centred on practical issues associated with age-related functional decline, including, for example, reduced dexterity. This thesis is the first comprehensive investigation into the use of MNs by the older population, providing an initial demonstration of MN delivery of multiple drugs, for future extension to a relevant in vivo model. The ongoing involvement of end-users and healthcare practitioners is recommended to facilitate future acceptance of MN technology by the older population and design of an age-appropriate delivery platform.
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