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Swallowing difficulties with oral drugs among polypharmacy patients attending community pharmacies

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Abstract

Background Swallowing difficulties are common and can affect patients’ ability to take solid oral dosage forms, thus compromising medication adherence. Strategies developed by patients to overcome such difficulties while taking medicines have seldom been described. Objective To determine prevalence and characteristics of swallowing difficulties among primary care patients attending their community pharmacies; to explore strategies developed by patients to overcome their difficulties, and health professionals’ awareness of these problems. Setting Prospective study with a semi-structured questionnaire in random community pharmacies located in two Swiss regions. Method In each pharmacy, an interviewer asked 16 questions to each consecutive patient (18 years and older) with a prescription for at least 3 different solid oral forms. Main outcome measure Quantification of number of patients with swallowing difficulties and detailed description of difficulties. Results Among 122 pharmacies, 59 (48 %) accepted to join the study and 410 patients were enrolled. Thirty-seven patients (9.0 %) reported ongoing swallowing difficulties, while 55 patients (13.4 %) reported past difficulties. For the majority of patients, difficulties occurred at each single dose (83.7 %), with a single medication (59.8 %) and lasted for less than 12 months (53.8 %). Number of tablets was not the main trigger. Swallowing difficulties impaired extremely daily life in 12 % of the patients. Intentional non adherence (23 % of patients) and altering the oral dose formulation were the most common and potentially harmful strategies used by patients to overcome their swallowing difficulties. According to the patients, pharmacists and physicians rarely inquired about their swallowing difficulties. Conclusion We report a fairly high prevalence of swallowing difficulties in polypharmacy patients attending their community pharmacies. Pharmacists have to interview patients on their swallowing difficulties in a more systematic way, support patients in finding solutions and refer them to their physician if necessary to ensure continuity in care.

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Acknowledgments

The authors thank all the community pharmacists who took part in the study. This work was presented as a poster at the 39th European Symposium on Clinical Pharmacy ESCP, 21-23 October 2010, Lyon, France.

Funding

There was no external funding for this study.

Conflicts of interest

The authors report no conflict of interest. All named authors are responsible for the content and writing of the paper.

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Authors and Affiliations

  1. Community pharmacy, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland

    Julien Marquis, Valérie Payot & Olivier Bugnon

  2. Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland

    Julien Marquis, Marie-Paule Schneider & Olivier Bugnon

  3. Pharmaceutical Care Research Group, Pharmaceutical Sciences, University of Basel, Basel, Switzerland

    Anne-Christine Cordonier, Kurt E. Hersberger & Isabelle Arnet

Authors
  1. Julien Marquis
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  2. Marie-Paule Schneider
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  3. Valérie Payot
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  4. Anne-Christine Cordonier
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  5. Olivier Bugnon
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  6. Kurt E. Hersberger
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  7. Isabelle Arnet
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Correspondence to Isabelle Arnet.

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Marquis, J., Schneider, MP., Payot, V. et al. Swallowing difficulties with oral drugs among polypharmacy patients attending community pharmacies. Int J Clin Pharm 35, 1130–1136 (2013). https://doi.org/10.1007/s11096-013-9836-2

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  • DOI: https://doi.org/10.1007/s11096-013-9836-2

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