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June 3, 2015
Pill-Swallowing Techniques Effective Even in Toddlers

Chapel Hill, NC—Getting children to take their medicine, especially those in tablet or capsule form, can be a challenge even for the most persuasive parents and caregivers. Yet very few good quality studies on how to resolve pill swallowing issues have been published in the last quarter century, according to a new review.

The report, published recently in the journal Pediatrics, offers some positive news, however, for parents and caregivers: The few interventions studied—behavioral therapy, flavored throat spray, specialized pill cup, simple verbal instructions, and head posture training—are fairly successful. That’s based on only five published studies that met the inclusion criteria for the analysis by University of North Carolina School of Medicine researchers.

“Nevertheless, our review does show that the failure to swallow pills is a barrier that can be overcome in the pediatric population,” the authors write. “All selected articles in this review demonstrated that their intervention was successful in improving pill swallowing abilities in more than half of their study population. Furthermore, the articles showcased a number of different strategies that a healthcare provider can use to facilitate the development of pill swallowing skills.”

Simply trying to remedy the problem can be beneficial, according to the researchers, who add, “A major reason for the success of all the interventions is that every study recognized and specifically addressed problems with pill swallowing. As a result, there was a conscious effort to help children with their difficulties in swallowing pills.”

The review also points out that younger children can have more success in swallowing pills than parents sometimes fear. Some of the interventions were tested in children as young as 2 years old, according to the authors, who add, “In fact, one study found that younger children (age 4–5 years) needed less training sessions than older children to learn how to swallow pills.”

That may be because younger patients are pill naive before the training and therefore have had fewer negative experiences when learning to swallow pills than older patients, they note, explaining, “Therefore, teaching children how to swallow pills at an earlier age can help prevent a barrier to medication adherence and can be easier than waiting until they are older.”

For the study, researchers performed a comprehensive PubMed search and a bibliography review to identify articles for review between December 1986 and December 2013.

Ultimately, four cohort studies and one case series—all of which involved more than 10 participants aged 0 to 21 years with pill swallowing difficulties without a comorbid condition affecting their swallowing—met the criteria, with all five finding their intervention to be successful in teaching children how to swallow pills.

“Pill swallowing difficulties are a barrier that can be overcome with a variety of successful interventions,” the authors conclude. “Addressing this problem and researching more effective ways of implementing these interventions can help improve medication administration and compliance in the pediatric population.”
U.S. Pharmacist Social Connect