Application of a screening tool to understand the medication habits of patients with swallowing difficulty: a prospective observational study

Background: Difficulty swallowing solid oral dose forms can result in non-adherence and thus can negatively impact patient outcomes. It can be challenging for healthcare professionals to readily identify patients who present with this difficulty within the hospital setting. Aim: To apply the “Swallowing Difficulties with Medication Intake and Coping Strategies” (SWAMECO) questionnaire at admission to hospital to elucidate the medication habits of patients when taking medication at home. Method: This prospective observational study took place in acute urban teaching hospital in Ireland in July 2023. Eligible adults completed the SWAMECO, describing their difficulty and the coping strategies used. Data on age, sex, medicines and disease states, as per International Classification of Diseases and Related Health problems (ICD-10) were collected. Results: Self-reported prevalence of swallowing difficulties was 10% (41/409) of whom, 14 patients (median age; 67 years (range 40–86 years), 78.6%; female) completed the SWAMECO. The majority reported having a sensation of medication getting stuck in the pharynx. Swallowing difficulty caused anxiety for some patients and contributed to non-adherence. The most common coping strategy was splitting tablets. Paracetamol was the most frequent solid oral dose form associated with swallowing difficulty and hypertension was the most diagnosed condition. Alternative formulations were available for over half (56%) of the solid oral dose forms prescribed. Conclusion: The SWAMECO can provide valuable information by identification of patients with swallowing difficulty. This may facilitate clinical pharmacist intervention to ensure safe administration of oral medicines and to enhance patient adherence by providing tailored solutions.