THE VIEW POINT OF HEALTHCARE PROFESSIONALS ABOUT SWALLOWING DIFFICULTIES FOR MEDICATION IN PATIENTS
Main Article Content
Keywords
Solid Dosage Form, Swallowing Difficulty, Dosage Form Amendment, Healthcare Professionals
Abstract
Patients often encounter swallowing difficulties for their medication and make amendments in the oral solid dosage formulations without informing the healthcare professionals. This may result in generation of adverse effects. Pharmacists can be the first point of contact in the community for people seeking advice about their medication whereas the doctors can consider about the swallowing capabilities of patients while prescribing medication. This study was aimed to assess the perceptions and practices of healthcare professionals regarding swallowing difficulties in patients and amendments in the medication for them. A descriptive, non-interventional, cross sectional study was conducted from December 2018 to March 2019. Structured and pretested questionnaires were distributed among doctors and pharmacists at their workplaces in Karachi, Pakistan. The researchers then collected completely filled questionnaires to analyze the data by using SPSS version 21.0. A total of 209 health professionals participated in the study among which 104 were pharmacists and 105 were doctors. 124 health professionals (doctors= 64, pharmacists= 60) asked patients about having any difficulty in swallowing solid oral formulations (p=0.040). Swallowing difficulty was mostly reported in elderly by 83 health professionals (doctors= 33, pharmacists = 50), and then in children by 40 health professionals (doctors= 29, pharmacists= 11) (p= 0.001). To overcome swallowing problem, 70 health professionals (doctors= 48, pharmacists = 22) recommended patients to have plenty of water while 63 health professionals (doctors= 29, pharmacists = 34) suggested to crush the tablet for consumption (p= 0.000). The patients were instructed by 46 health professionals (doctors= 09, pharmacists= 37) to use alternative dosage form in case of swallowing problem.
Conclusion: The healthcare professionals have different viewpoints related to medication practice and amendments in therapy in case swallowing issues arise for some patients. Some patients are habitual to amend their medication even when there was no need; also instruction is not taken from healthcare professionals in this respect. Healthcare professionals should be ardent to educate patients about problems involving medication intake and amendments to be made in this regard.
References
2. Bonacucina, G., Logrippo, S., Cespi, M. et al. Chemical and microbiological stability studies of an aqueous solution of pravastatin sodium salt for drug therapy of the dysphagic patients. European Journal of Hospital Pharmacy, 2016, 23: 288-293
3. Lau, E. T., Steadman, K. J., Cichero, J. A. et al. Pharmacist, general practitioner, and nurse perceptions, experiences, and knowledge of medication dosage form modification. Integrated Pharmacy Research and Practice, 2013, 3: 1-9.
4. Quinzler, R., Szecsenyi, J. & Haefeli, W. et al. Tablet splitting: patients and physicians need better support. European journal of clinical pharmacology, 2007, 63: 1203-1204
5. Quinzler, R., Gasse, C., Schneider, A. et al. The frequency of inappropriate tablet splitting in primary care. European journal of clinical pharmacology, 2006, 62: 1065-1073.
6. Lau, E. T., Steadman, K. J., Mak, M. et al. Prevalence of swallowing difficulties and medication modification in customers of community pharmacists. Journal of Pharmacy Practice and Research, 2015, 45: 18-23
7. Wirth, R., Dziewas, R., Beck, A. M. et al. Oropharyngeal dysphagia in older persons–from pathophysiology to adequate intervention: a review and summary of an international expert meeting. Clinical interventions in aging, 2016, 11: 189.
8. Zuliani, G., Galvani, M., Sioulis, F. et al. Discharge diagnosis and comorbidity profile in hospitalized older patients with dementia. International journal of geriatric psychiatry, 2012, 27: 313-320
9. World Gastroenterology Organization, 2014. Dysphagia global guidelines & cascades http:// www.worldgastroenterology.org/UserFiles/file/guidelines/dysphagia-english-2014.pdf
10. Kelly, J., Wright, D. & Wood, J. et al. Medicine administration errors in patients with dysphagia in secondary care: a multi‐centre observational study. Journal of advanced nursing, 2011, 67: 2615-2627.
11. Logrippo, S., Ricci, G., Sestili, M. et al. Oral drug therapy in elderly with dysphagia: between a rock and a hard place! Clinical interventions in Aging, 2017, 12: 241.
12. Downey, C. E., Thakerar, A. & Kirsa, S. Don't rush to crush: audit of modification to oral medicines for patients with swallowing difficulties. Journal of Pharmacy Practice and Research, 2015, 45: 146-151
13. Stubbs, J., Haw, C. & Dickens, G. Dose form modification–a common but potentially hazardous practice. A literature review and study of medication administration to older psychiatric inpatients. International psychogeriatrics, 2008, 20: 616-627
14. Habib, W. A., Alanizi, A. S., Abdelhamid, M. M. et al. Accuracy of tablet splitting: Comparison study between hand splitting and tablet cutter. Saudi Pharmaceutical Journal, 2014, 22: 454-459
15. Hommel, K. A. & Baldassano, R. N. Brief report: Barriers to treatment adherence in pediatric inflammatory bowel disease. Journal of pediatric psychology, 2010, 35: 1005-1010
16. Marquis, J., Schneider, M.-P., Payot, V. et al. Swallowing difficulties with oral drugs among polypharmacy patients attending community pharmacies. International journal of clinical pharmacy, 2013, 35: 1130-1136
17. MC Gillicuddy, A., Kelly, M., Crean, A. M. et al. The knowledge, attitudes and beliefs of patients and their healthcare professionals around oral dosage form modification: A systematic review of the qualitative literature. Research in Social and Administrative Pharmacy, 2017, 13: 717-726
18. Raosoft. Sample Size Calculator. http://www.raosoft.com/samplesize.html, Accessed 6 July /wml.txt/980810-2.html, 1998-08-16/1998-10-04.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Fakhsheena Anjumj
Department of Pharmacy Practice, Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Pakistan
Mirza Tasawer Baig
Department of Pharmacy Practice, Faculty of Pharmacy, Ziauddin University, Karachi, Pakistan
Noor Jahan
Department of Pharmacology, Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Pakistan
Sana Shamim
Department of Pharmaceutical Chemistry, Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Pakistan
Sana Ghayas
Department of Pharmaceutics, Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Pakistan
Saima Mahmood
Department of Pharmacology, Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Pakistan
Moona Mehboob
Department of Pharmaceutical Chemistry, Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Pakistan