Swallowing an underestimated problem in adults, says survey

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A survey has found that difficulties in swallowing pills is
widespread among adults, but is rarely discussed with doctors and
can prevent some people from taking their medicine. The findings
suggest that pharmaceutical companies should devote more resources
to developing user-friendly dosage forms.

The survey, conducted in the US, revealed that 40 per cent of American adults have experienced difficulty swallowing pills, even though most have had no problems swallowing food or liquid. Of those who experience difficulty swallowing their medications, 14 per cent have delayed taking doses of their medication, 8 per cent have skipped a dose and 4 per cent have discontinued using their medication.

In addition, less than a quarter of adults who have difficulty swallowing their medication have ever discussed the problem with a health professional. In 58 per cent of these cases the health professional brought up issue, with 42 per cent (or one in 10 of the total sample) initiating the conversation themselves.

Worth Boyce, director of the Joy McCann Culverhouse Centre for Swallowing Disorders at the University of South Florida in the US, said that the study has shown that the scale of non-compliance with prescribed dosing is alarming.

"Non-adherence and failure of patients to inform their doctor can result in serious health consequences,"​he pointed out, adding that it can also limit physicians' ability to successfully treat patients and increases the cost of health care.

The survey also reveals some interesting information about how people respond to the design of oral dosage forms. The size of the pill was unsurprisingly the factor most likely to make a patient hesitate before taking it, reported by 84 per cent of respondents. But nearly a third (29 per cent) also worried about its shape, and one in 10 said they had selected pills based on a judgement of how difficult they would be to take.

Gender, age differences

The survey found that women were much more likely to have difficulties swallowing than men. More than half of the women surveyed (51 per cent) said they had a problem taking pills, compared to 27 per cent of men. And younger people (aged between 18 and 64) also reported more difficulties than those aged 65 and over (44 per cent and 26 per cent, respectively).

Most people that had problems taking pills described the sensations as having a pill stuck in their throat (80 per cent), having a bad after taste in their mouth (48 per cent), or gagging (32 per cent).

The survey suggested that people are willing to switch to alternative oral dosage forms, including chewable or rapid-dissolve tablets.

Specific questions on the rapidly-dissolving product category revealed some useful insights. For example, among the 'waverers' who were either unsure or somewhat likely to try these products, the factors with the greatest importance underlying their decision are the ability to easily transport their pills (80 per cent), ease of administration (78 per cent), and no need for preparation (76 per cent).

No need for water when swallowing pills scored well (65 per cent) while the taste of the pill was also a major factor (61 per cent).

The survey of 679 adults (513 ages 18-64, 166 age 65 and older) was funded by the US affiliate of Germany's Schwarz Pharma.

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