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A spoonful of sugar helps the medicine go down? A review of strategies for making pills easier to swallow

Authors Forough AS, Lau ETL, Steadman KJ, Cichero JAY, Kyle GJ, Serrano Santos JM, Nissen LM

Received 3 February 2018

Accepted for publication 31 March 2018

Published 26 July 2018 Volume 2018:12 Pages 1337—1346

DOI https://doi.org/10.2147/PPA.S164406

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Doris YP Leung

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen


Video abstract presented by Dr Aida Sefidani Forough.

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Aida Sefidani Forough,1 Esther TL Lau,1 Kathryn J Steadman,1,2 Julie AY Cichero,1,2 Greg J Kyle,1 Jose Manuel Serrano Santos,1 Lisa M Nissen1

1School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia; 2School of Pharmacy, University of Queensland, Brisbane, QLD, Australia

Abstract: Solid oral dosage forms such as tablets and capsules are generally the preferred method of drug delivery due to their convenience, cost, and acceptability. However, for many people, it can be a challenge to swallow solid oral medications, even those with healthy swallowing function. This review describes current strategies available to facilitate medication administration to otherwise healthy people with pill-swallowing difficulties. In general, restoring and maintaining the ability to swallow pills whole should ideally be the first choice in managing people with pill-swallowing difficulties. A number of strategies can potentially make it easier to swallow pills whole. These include postural adjustments, using pill-swallowing aids, and teaching pill-swallowing techniques. Where these are not successful or appropriate, then other approaches have to be considered using alternative formulations/routes of administration or deprescribing. If there is no other option, and it is not directly contraindicated for each specific medication dosage form, pills may be modified and mixed in foods and drinks to aid swallowing. In conclusion, people with pill-swallowing difficulties can benefit from a number of strategies designed to facilitate swallowing medications. However, these strategies should be further evaluated with regard to the evidence relating to both their efficacy and safety.

Keywords: swallowing difficulties, pill swallowing, medication administration, oral dosage forms, tablets, capsules

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