title: Swallowing difficulties with oral drugs among polypharmacy patients attending community pharmacies.
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.
  
  
  METHODS
  Prospective study with a semi-structured questionnaire in random community pharmacies located in two Swiss regions.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Community pharmacy, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland.
authors: Julien
authors: J
authors: Marquis
authors: Marie-Paule
authors: MP
authors: Schneider
authors: Valérie
authors: V
authors: Payot
authors: Anne-Christine
authors: AC
authors: Cordonier
authors: Olivier
authors: O
authors: Bugnon
authors: Kurt E
authors: KE
authors: Hersberger
authors: Isabelle
authors: I
authors: Arnet
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003157:Community Pharmacy Services; D003680:Deglutition Disorders / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D010595:Pharmacists / Q000458:organization & administration*; D019338:Polypharmacy; D015995:Prevalence; D024382:Professional Role; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013557:Switzerland; D013607:Tablets; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D004364:Pharmaceutical Preparations; D013607:Tablets
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