Solid oral medications are preferred over intravenous or liquid formulations; however, difficulty swallowing solid medication remains a common barrier to adherence. Previous reviews have demonstrated limited evidence on interventions to improve solid medication swallowing abilities. PubMed, Medline (OVID), CINAHL, Scopus, and Web of Science databases were searched for interventions to improve the pediatric population’s ability to swallow solid medications. We included studies in English published after the latest review, from January 2014 through April 2022, with pediatric patients not having comorbid conditions affecting swallowing ability. The authors independently reviewed each study’s sampling strategy, study design, and the strength of outcome measures and assigned a numerical rating representing “poor,” “fair,” or “good” for each category. Individual ratings were averaged per category and a final quality rating score given based on the average of all 3 categories. Our search identified 581 unique records; 10 were included in the final review. Interventions varied and included behavioral therapies and novel products or medication formulations. Three received a “good” quality rating, 5 were “fair,” and 2 were “poor.” All studies showed their intervention(s) to be successful in improving a child’s ability to swallow solid oral medications. Despite the availability of several different effective interventions, pediatric providers do not routinely address patients’ difficulty with swallowing solid oral medications. Patients would benefit from implementation of a universal screening process followed by a guideline for appropriate patient-centered interventions; the opportunity exists to use this process as a national quality benchmark reflecting institutional commitment to high-value care.
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Review Article|
April 06 2023
Hard to Swallow: A Review of Interventions to Improve Swallowing Solid Medication
Caryn J. VandenBerg, MD, FAAP;
Caryn J. VandenBerg, MD, FAAP
aDivision of Hospital Based Medicine
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Alyssa Adams, MD;
Alyssa Adams, MD
aDivision of Hospital Based Medicine
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Robyn Bockrath, MD, MEd;
Robyn Bockrath, MD, MEd
aDivision of Hospital Based Medicine
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SangHee Kim, MD;
SangHee Kim, MD
aDivision of Hospital Based Medicine
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Giselle Rodriguez, MD;
Giselle Rodriguez, MD
aDivision of Hospital Based Medicine
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Andrea Fawcett, MLIS;
Andrea Fawcett, MLIS
bReference Library
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Ravi Jhaveri, MD, FAAP
cDivision of Infectious Diseases, Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, Illinois
Address correspondence to Ravi Jhaveri, MD, Division of Infectious Diseases, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E Chicago Ave, Box 20, Chicago, IL 60611-2991. E-mail: ravi.jhaveri@northwestern.edu
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Address correspondence to Ravi Jhaveri, MD, Division of Infectious Diseases, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E Chicago Ave, Box 20, Chicago, IL 60611-2991. E-mail: ravi.jhaveri@northwestern.edu
Hosp Pediatr (2023) 13 (5): e123–e132.
Citation
Caryn J. VandenBerg, Alyssa Adams, Robyn Bockrath, SangHee Kim, Giselle Rodriguez, Andrea Fawcett, Ravi Jhaveri; Hard to Swallow: A Review of Interventions to Improve Swallowing Solid Medication. Hosp Pediatr May 2023; 13 (5): e123–e132. https://doi.org/10.1542/hpeds.2021-006497
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