SP8 Embedding ‘pill’ swallowing training across a UK School of pharmacy
Authors: McCloskey Alice 
Published: June 2023

Aim

To validate an educational tool (Health Education England Learning for healthcare ‘KidzMed’ programme) to prepare student pharmacists for patient counselling on effective swallowing of solid oral dosage forms (‘pills’).1Through receiving and applying their learning in a simulated environment it was hoped that participants would feel confident to teach children to swallow pills.

Method

University ethics was sought and granted (PBS/2020-21 04). Our final year MPharm students completed a KidzMed workshop within their paediatric module. Students completed an eLearning component (15-minute video, 30 minute interactive content) as pre-work prior to attending a 90 minute in-person simulation and supported workshop with experienced pill school trainers. Participants role played in pairs using sports-capped water bottles and pill packs containing sweets and HPMC capsules of various sizes. Participation was entirely voluntary.

Pre and post training data collection was anonymous via Microsoft Forms. Pre-training data included participant reflection on their own pill-swallowing experiences and pill swallowing difficulties using a validated tool PILL-5.2Post training session participants repeated PILL-5 and provided feedback on the learning and its usefulness for future practice.

Results

Overall, 81 students were trained with 65 completing the post-training feedback. At baseline 12 (15%) had a PILL-5 scored ≥6 indicating pill swallowing difficulties (similar to published pill swallowing difficulty 12-54% prevalence in non-dysphagia adults).3,4Post-training, all 65 (100%) reported successfully swallowing the ‘pills’ provided. Participants recognised the benefits of this learning for both children and adults (n= 61), 3 viewed it as suitable for children only, and 1 adult only. All agreed/strongly agreed that pill swallowing training is useful and their comfort in counselling patients, parents/carers. Feedback was positive with the pre-work and workshops viewed as ‘just right’. They described the interactive nature, transferability and benefits of the learning for future practice. A handful expressed awkwardness acting with their peer group. All would recommend the training to a colleague or friend.

Conclusions

In a UK first, we successfully tested pill swallowing training within a School of Pharmacy MPharm curriculum. A blended method was welcomed by students who enjoyed the simulated sessions. Students with pre-existing swallowing difficulties successfully learnt to swallow solid oral dosage forms from each other. Counselling on effective medicines use is a key role for pharmacists and students see its relevance to future practice.

References

Tse Y, Vasey N, Dua D,et al. The KidzMed project: teaching children to swallow tablet medication.Arch Dis Child2020;105:1105-1107.

Nativ-Zeltzer N, Bayoumi A, Mandin V et al. Validation of the PILL-5: A 5-item patient reported outcome measure for pill dysphagia.Front Surg.2019;6:43.

Arnet I, Messerli M, Oezvegyi J,et al. Translation to English, cross-cultural adaptation, and pilot testing of the self-report questionnaire on swallowing difficulties with medication intake and coping strategies (SWAMECO) for adults with polypharmacy. BMJ Open. 2020;10:e036761.

Fields J, Go JT, Schulze KS. Pill properties that cause dysphagia and treatment failure.Curr Ther Res Clin Exp.2015;77:79-82.