Start Date

11-6-2020 12:00 AM

Description

Difficulty swallowing pills has become an increasing complaint among patients visiting swallow evaluation centers across the globe. Deficits are reported in healthy individuals as well as in clinical populations. In the USA, 40% of 679 persons responding to a survey reported difficulty swallowing pills (Business Wire, 2009). In an effort to facilitate pill intake, several modifications have been reported: use of liquid formulations, crushing tablet, opening capsule, whole pill mixed with food or via feeding tube (Cornish, 2005). A survey of 40 nurses revealed the most common modification was to use apple sauce (Riquelme et al., 2009). Current literature on swallowing pills focuses mostly on esophageal transit of pills in adults and on how to feed pills to children. However, little attention has been given to the physiology responsible for pill swallowing. The purpose of this prospective study was to identify patterns employed by adults during self-administration of pills and determine differences by medium used (thin liquid water, semi-solid applesauce). Participants included 42 adults, 28 female, referred for videofluoroscopy (VFSS). Age range was 86-27; mean of 66 years. Fluoroscopy data were captured on the Kay Pentax DSW. The contrast material employed was a barium-filled capsule. Participants completed two trials with water and two with applesauce. A total of 129 swallows were analyzed: 71 pill + water and 58 pill + apple sauce. Results revealed 13 patterns for swallowing pills, with cohesive swallow (38.85%), lingual pumping (16.56%), and lingual hesitation (15.92%) among the most prevalent. Additionally, it was found that 63% of the sample utilized different patterns based on medium employed to transport the pill (water vs apple sauce), and 18.2% utilized different patterns across all trials. This study supports the need to further understand changes to the swallow mechanism inherent in transporting a pill, so as to improve management and compliance and reduce unnecessary changes in formulations.

COinS
 
Jun 11th, 12:00 AM

Quantifying differences in pill swallow patterns in adults

Difficulty swallowing pills has become an increasing complaint among patients visiting swallow evaluation centers across the globe. Deficits are reported in healthy individuals as well as in clinical populations. In the USA, 40% of 679 persons responding to a survey reported difficulty swallowing pills (Business Wire, 2009). In an effort to facilitate pill intake, several modifications have been reported: use of liquid formulations, crushing tablet, opening capsule, whole pill mixed with food or via feeding tube (Cornish, 2005). A survey of 40 nurses revealed the most common modification was to use apple sauce (Riquelme et al., 2009). Current literature on swallowing pills focuses mostly on esophageal transit of pills in adults and on how to feed pills to children. However, little attention has been given to the physiology responsible for pill swallowing. The purpose of this prospective study was to identify patterns employed by adults during self-administration of pills and determine differences by medium used (thin liquid water, semi-solid applesauce). Participants included 42 adults, 28 female, referred for videofluoroscopy (VFSS). Age range was 86-27; mean of 66 years. Fluoroscopy data were captured on the Kay Pentax DSW. The contrast material employed was a barium-filled capsule. Participants completed two trials with water and two with applesauce. A total of 129 swallows were analyzed: 71 pill + water and 58 pill + apple sauce. Results revealed 13 patterns for swallowing pills, with cohesive swallow (38.85%), lingual pumping (16.56%), and lingual hesitation (15.92%) among the most prevalent. Additionally, it was found that 63% of the sample utilized different patterns based on medium employed to transport the pill (water vs apple sauce), and 18.2% utilized different patterns across all trials. This study supports the need to further understand changes to the swallow mechanism inherent in transporting a pill, so as to improve management and compliance and reduce unnecessary changes in formulations.

 

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