2 tips to help your patients swallow their medications.

The simple act of swallowing medications can be a real problem for some of our patients. The resultant gagging and choking may pose some aspiration risk, and may result in a reluctance to take the medications at all.

There are many anecdotal methods around to help swallow tablets, but this study from Germany presents 2 evidence based approaches.

This was a cross-sectional study of 151 adults ranging in age from 18 to 85 who were asked to swallow 16 differently shaped placebo tablets and capsules (including a ‘very large tablet’) and then rate the ease of ingestion on an 8-point Likert scale.

Here are the two recommended methods.

Method 1: The Pop-Bottle.

  1. Fill a flexible plastic water bottle with water.
  2. Ask the patient to place the tablet on their tongue and close their lips tightly around the opening of the bottle.
  3. Tell them to take a drink from the bottle, keeping contact between the bottle and their lips and using a swift sucking motion.
  4. No air should be allowed to enter the bottle, rather it should collapse inwards as the patient sucks and swallows.

Method 2: The Forward Lean.

  1. The patient should be in an upright position.
  2. Tell the patient to place the capsule on their tongue.
  3. Ask them to take a medium sip of water, but not to swallow it.
  4. Ask them to bend the head forwards by tilting their chin towards their chest.
  5. Tell them to swallow the capsule with the head bent forward.

These methods were found to lead to significant increase in ease of ingestion amongst participants as well as higher rates of successful swallow on the fist try, fewer reports of “unpleasant feelings in the throat” and less instances of pills ‘getting stuck’.

The authors concluded:

This study showed that 2 specific swallowing techniques notably improved the ease of swallowing tablets and capsules in participants with and without swallowing difficulties. To our knowledge this is the first study that has shown the effectiveness of the pop-bottle method; all other data on this subject are anecdotal. However, reclining the head while swallowing may increase the risk for penetration and aspiration. This method should, therefore, be used in dysphagia only after consultation of a physician or speech therapist.
The […] 2 targeted techniques to facilitate tablet and capsule intake were remarkably effective and easy to adopt in the general population including patients with swallowing difficulties, and should therefore be generally recommended.

1. Two Techniques to Make Swallowing Pills Easier [Internet]. [cited 2014 Nov 11]. Available from: http://annfammed.org/content/12/6/550.full

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