{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T12:38:01Z","timestamp":1779367081293,"version":"3.53.0"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T00:00:00Z","timestamp":1616112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The paediatric population has a low adherence and acceptance rate of unpalatable medicines. This study aimed to determine whether eating chocolate immediately prior to drug administration would help to mask the bitter taste of a drug. The difference in taste masking efficacy between white, milk and dark chocolate was a secondary measure outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A controlled repeated measures crossover taste trial was conducted using a taste panel of 29 young healthy adults who met the criteria to differentiate intensity in bitterness taste. Participants separately tasted solutions of quinine, flucloxacillin and clindamycin using the swill and spit method, singularly and following blinded prior administration of white, milk or dark chocolate. Drug solutions administered without prior chocolate served as controls. Bitterness score for each tasting was recorded using a 5\u2010point scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Regardless of chocolate type, mean taste scores with prior chocolate for quinine (range 2.00\u20132.34), clindamycin (3.72\u20133.83) and flucloxacillin (3.38\u20133.45) were all lower than mean scores for respective drugs without chocolate (3.24, 4.75 and 4.28, respectively; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001 for all comparisons). Dark chocolate was most efficacious for masking the bitter taste of quinine, but the differences in taste masking efficacy between dark, milk and white chocolates were not statistically significant for flucloxacillin and clindamycin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Prior administration of chocolate results in lower perceived bitterness compared to control tastings of quinine, flucloxacillin and clindamycin solutions; however, there is no clear difference in this effect between the dark, milk and white chocolates used in this study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.15448","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T15:38:41Z","timestamp":1616168321000},"page":"1267-1273","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Prior administration of chocolate improves the palatability of bitter drugs: The <scp>Choc\u2010with\u2010Med<\/scp> study"],"prefix":"10.1111","volume":"57","author":[{"given":"Shannon","family":"Truong","sequence":"first","affiliation":[{"name":"School of Medicine The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6266-6874","authenticated-orcid":false,"given":"Edith Kai Yan","family":"Tang","sequence":"additional","affiliation":[{"name":"Division of Pharmacy, School of Allied Health The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Nazim","family":"Khan","sequence":"additional","affiliation":[{"name":"School of Mathematics and Statistics The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minh Ngoc","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Division of Pharmacy, School of Allied Health The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8043-8541","authenticated-orcid":false,"given":"Britta S.","family":"von Ungern Sternberg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Management Perth Children's Hospital and The University of Western Australia (School of Medicine)  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen Wan Yan","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Trauma\/General Surgery Sir Charles Gairdner Hospital  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7307-0742","authenticated-orcid":false,"given":"Lee Yong","family":"Lim","sequence":"additional","affiliation":[{"name":"Division of Pharmacy, School of Allied Health The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,19]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Adherence to Long\u2010Term Therapies: Evidence for Action","author":"World Health Organization","year":"2003"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1133"},{"key":"e_1_2_7_4_1","unstructured":"EMA.Reflection paper: formulations of choice for the paediatric population. 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