Screening for, and overcoming, 'pill aversion' in community pharmacy using a novel educational tool: Hard pill to swallow?™.

McCloskey, AP ORCID: 0000-0003-3014-1624, Nesbit, J, Rathbone, AP, Vasey, N, McCabe, PG ORCID: 0000-0003-0464-4922, Flynn, S, Bal, S, Mulraney, K, Hamilton, S, Ali, H, Holebrooke-Steele, K, Tse, Y and Lim, EJ (2025) Screening for, and overcoming, 'pill aversion' in community pharmacy using a novel educational tool: Hard pill to swallow?™. Research in social & administrative pharmacy : RSAP. ISSN 1551-7411

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Abstract

Background
Solid oral dosage forms (pills) are commonly dispensed but frequently patients struggle to take these (pill aversion). This is rarely identified or addressed in clinical practice. The KidzMed programme teaches children to swallow pills, but to date it has not been used to support adults with pill aversion.
Objectives
- Assess in community pharmacy the acceptability of screening for pill aversion
- Test an educational leaflet tailored for adults to support with pill swallowing
Methods
Participants were recruited via pre-defined inclusion and exclusion criteria using convenience sampling at three Liverpool-based community pharmacies over a one-month period. A screening questionnaire was completed and adults >18 years identified with pill aversion (score of 6+ on the PILL-5 screening tool) supplied with an adapted educational leaflet from the KidzMed programme. Successful pill swallowing using the leaflet was assessed via phone-call two weeks later. Institutional ethics reference (PBS/2023-23/01).
Results
Overall, 246 participants were screened, 9 % (n = 22) were identified as having pill aversion. There was an association with younger age and female gender. Follow-up showed that the leaflet was well received, participants found it useful, had changed their pill swallowing technique because of it, and shared this knowledge with others.
Conclusions
Pill aversion is an underexplored issue. The positive impact of the adapted leaflet in adults reflects the success of KidzMed for children. Further work is needed to confirm the association of age and gender with pill aversion, and determine translatability of the adapted leaflet to a wider audience and other healthcare settings.
Keywords
Solid; oral dosage forms; Pills; Tablets; Capsules; Medication adherence; Community pharmacy; Patient education; Swallowing difficulties.

Item Type:	Article
Uncontrolled Keywords:	Capsules; Community pharmacy; Medication adherence; Patient education; Pills; Solid oral dosage forms; Swallowing difficulties; Tablets; 4203 Health Services and Systems; 4206 Public Health; 42 Health Sciences; Clinical Research; 1115 Pharmacology and Pharmaceutical Sciences; 1117 Public Health and Health Services; Pharmacology & Pharmacy; 4203 Health services and systems; 4206 Public health
Subjects:	R Medicine > R Medicine (General) R Medicine > RS Pharmacy and materia medica
Divisions:	Pharmacy and Biomolecular Sciences
Publisher:	Elsevier BV
Date of acceptance:	25 November 2025
Date of first compliant Open Access:	5 January 2026
Date Deposited:	05 Jan 2026 15:43
Last Modified:	05 Jan 2026 15:43
DOI or ID number:	10.1016/j.sapharm.2025.11.007
URI:	https://researchonline.ljmu.ac.uk/id/eprint/27789

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