An in vitro comparison of different providers to deliver four proton pump inhibitor products through a feeding tube

Background: It is unclear how delivery through a feeding tube compares between esomeprazole in water, lansoprazole oral disintegrating tablet in water, omeprazole/NaHCO₃ in water and simplified lansoprazole suspension. Aim: This in vitro study compared delivery through a narrow calibre (8F) feeding tube among four proton pump inhibitors when given by skilled [nurse; (n = 8)] or unskilled [lay; (n = 8)] providers. Methods: Following standard instruction, subjects were observed delivering each proton pump inhibitor in a sequential, but random, fashion to evaluate administration quality and time. Delivery was quantified using high-performance liquid chromatography methods and subject preferences were evaluated. Results: Delivery (%), similar between lansoprazole oral disintegrating tablet (95.7 ± 3.2) and omeprazole/NaHCO₃ (96.1 ± 3.0), was both greater for lansoprazole oral disintegrating tablet than esomeprazole in water (88.9 ± 8.6; P = 0.006) or simplified lansoprazole suspension (86.1 ± 9.5; P = 0.0001) and omeprazole/ NaHCO₃ than esomeprazole in water (P = 0.004) or simplified lansoprazole suspension (P < 0.001), and was not affected by prior subject experience. Quality was higher with both omeprazole/NaHCO₃ and lansoprazole oral disintegrating tablet than simplified lansoprazole suspension. Administration was quicker for lansoprazole oral disintegrating tablet than esomeprazole in water. Subjects preferred lansoprazole oral disintegrating tablet and omeprazole/NaHCO₃. Conclusions: When given through an in vitro feeding tube, omeprazole/NaHCO₃ and lansoprazole oral disintegrating tablet lead to greater drug delivery, improved administration quality and higher user satisfaction, than either esomeprazole in water or simplified lansoprazole suspension.