Patient-Centred Formulation Technologies for Complex Dosing Environments

Pharmaceutical technologies increasingly permit modification of dose, dosage-form geometry, release behaviour, administration route, and production location. However, technological flexibility does not necessarily make a medicine patient-centred because the same product may perform differently when confronted with swallowing limitations, developmental or age-related gastrointestinal physiology, dose-adjustment requirements, caregiver-mediated administration, or constrained home-use conditions. This scoping review examines how formulation technologies interact with patient capability, physiological variability, administration conditions, and delivery-system requirements in complex dosing environments. A scoping-review approach was used to organize recent evidence on age-appropriate dosage forms, administration and swallowing constraints, flexible and modular dosing, three-dimensional printing, long-acting delivery, device-enabled administration, and decentralized production. Evidence was charted according to technology characteristics, patient factors, pharmaceutical state, administration conditions, and the level at which performance was demonstrated. The evidence indicates that acceptability, manufacturability, dose flexibility, dissolution behaviour, prolonged release, and portability represent distinct dimensions rather than interchangeable indicators of patient-centred performance. Paediatric and geriatric applications especially expose mismatches between standardized products and heterogeneous physiological or administration states. Flexible and digitally manufactured dosage forms can address selected dose and usability constraints, but technical success does not establish clinical benefit, biopharmaceutical robustness, or suitability across settings. Patient-centred formulation design is better treated as a problem of conditional fit among the patient, dosage form, physiological environment, and administration system. Technologies should therefore be evaluated against the dosing environment they must tolerate rather than against customization capability alone.