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Identifying and addressing pill aversion in adults without physiological‐related dysphagia: A narrative review

McCloskey, AP, Penson, PE, Tse, Y, Abdelhafiz, MA, Ahmed, SN and Lim, EJ (2022) Identifying and addressing pill aversion in adults without physiological‐related dysphagia: A narrative review. British Journal of Clinical Pharmacology. ISSN 0306-5251

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Open Access URL: https://doi.org/10.1111/bcp.15463 (Published version)


Solid oral dosage forms (SODFs), (often called pills by patients) are the default formulation to treat medical ailments. Beneficial therapeutic outcomes rely on patients taking them as directed. Up to 40% of the population experience difficulties swallowing SODFs, resulting in reduced adherence and impaired therapeutic efficacy. Often associated with children, this also presents in adults with dysphagia, and without any organic dysphagia (non-physiological-related or functional dysphagia). This review aims to identify and appraise current interventions used to identify and overcome pill aversion in adults with functional dysphagia. As per our protocol - PROSPERO (CRD42021227095), a comprehensive search of the literature was conducted. Articles reporting pill aversion in adults - aged 18 years+ with no underlying cause, history of, or existing dysphagia were included. Study quality was determined using the STROBE tool for observational studies. A narrative synthesis of the findings was prepared. We identified 18 relevant cohort studies, these demonstrate that pill aversion is a global problem. Perceived ease of and/or SODF swallowability appears to be influenced by female gender, younger age, co-morbidities e.g. depression, and physical SODF properties. Patients often modify their medicines rather than raise this issue with their healthcare team. Screening for pill aversion is haphazard but controlled postural adjustments, coating SODFs and behavioural interventions appear to be successful solutions. SODF swallowing difficulties are a barrier to effective medication use. Healthcare professionals must recognise that pill aversion is a problem requiring identification through effective screening and resolution by training interventions, appropriate formulation selection, or specialist referral.

Item Type: Article
Uncontrolled Keywords: 1115 Pharmacology and Pharmaceutical Sciences; Pharmacology & Pharmacy
Subjects: R Medicine > RM Therapeutics. Pharmacology
Divisions: Pharmacy & Biomolecular Sciences
Publisher: Wiley
SWORD Depositor: A Symplectic
Date Deposited: 19 Jul 2022 11:39
Last Modified: 16 Aug 2022 10:00
DOI or ID number: 10.1111/bcp.15463
URI: https://researchonline.ljmu.ac.uk/id/eprint/17252
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