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Adams R, Crisp DA, Thomas J. The Psychological Impacts of Pill Dysphagia: A Mixed Methods Study. Dysphagia 2024:10.1007/s00455-024-10703-4. [PMID: 38634944 DOI: 10.1007/s00455-024-10703-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 03/26/2024] [Indexed: 04/19/2024]
Abstract
Pill dysphagia is a common problem amongst older adults, with significant health consequences. Previous research has found that dysphagia can negatively affect an individuals mental health and wellbeing. However, this research has not been extended to pill-specific dysphagia, which presents distinct differences from the challenges posed by swallowing food and liquids. These differences extend to causes, demographics, and physical health ramifications. This study aimed to address this gap in the literature by investigating the effects of pill dysphagia on the wellbeing of older adults. A community sample of 132 Australians aged 65-97 years completed a survey about their wellbeing and difficulty swallowing pills. Thirty-one participants who met the criteria for pill dysphagia completed further open-ended questions detailing the effects of pill dysphagia and how they manage it. Analyses of the quantitative data indicated that difficulty swallowing pills was unrelated to negative affect but negatively related to positive affect, life satisfaction, and eudemonic wellbeing. Supplementary analyses controlling for health-related variables found no significant relationships between difficulty swallowing pills and wellbeing. Responses to the open-ended questions revealed a range of physical, psychological, and practical impacts of pill dysphagia, and successful and unsuccessful methods used to assist in swallowing pills. The findings partially support the hypothesised effects of pill dysphagia on wellbeing. However, further research is required to establish if more severe pill dysphagia predicts wellbeing over and above self-rated health. Future interventions should incorporate wellbeing promotion strategies for older adults with pill dysphagia.
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Affiliation(s)
- Rowan Adams
- Faculty of Health, University of Canberra, Canberra, ACT, 2617, Australia
| | - Dimity A Crisp
- Faculty of Health, University of Canberra, Canberra, ACT, 2617, Australia.
| | - Jackson Thomas
- Faculty of Health, University of Canberra, Canberra, ACT, 2617, Australia
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2
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Damuzzo V, Brusegan A, Bin A, Realdon N, Zardo S. Evaluation of resources for effective decision-making about drug manipulation. Eur J Hosp Pharm 2024:ejhpharm-2024-004110. [PMID: 38413178 DOI: 10.1136/ejhpharm-2024-004110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Affiliation(s)
- Vera Damuzzo
- School of Hospital Pharmacy, Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padova, Veneto, Italy
| | - Adriana Brusegan
- School of Hospital Pharmacy, Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padova, Veneto, Italy
| | - Anna Bin
- Territorial Pharmaceutical Assistance, Azienda ULSS 3 Serenissima, Venezia, Veneto, Italy
| | - Nicola Realdon
- School of Hospital Pharmacy, Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padova, Veneto, Italy
| | - Susanna Zardo
- Territorial Pharmaceutical Assistance, Azienda ULSS 3 Serenissima, Venezia, Veneto, Italy
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3
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Sajatovic M, Patel A, Hebert M, Mar A, Moore R, Bristow A, Farahmand K, Siegert S. Crushing the Contents of Valbenazine Capsules for Potential Addition to Soft Foods or Administration via Gastrostomy Tube. Clin Ther 2023; 45:1222-1227. [PMID: 37953076 DOI: 10.1016/j.clinthera.2023.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/25/2023] [Accepted: 09/28/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE One-capsule, once-daily valbenazine is approved for tardive dyskinesia and under evaluation for chorea associated with Huntington's disease, conditions in which patients often experience dysphagia. In vitro studies were conducted to assess the suitability of crushing the contents of valbenazine capsules (40 and 80 mg) for mixing with soft foods or liquids or administration via a gastrostomy tube (G-tube). METHODS In study 1, the dissolution of whole valbenazine capsules and crushed capsule contents were measured serially for 1 hour. In study 2, valbenazine recovery was evaluated after crushed contents were mixed with soft foods, buffer solutions (pH range, 1.2-6.8), and fed-state simulated gastric fluid. In study 3, valbenazine recovery was evaluated after crushed contents were dispersed in water and delivered via a G-tube. In studies 2 and 3, acceptable valbenazine recovery was 90% to 110%. FINDINGS Study 1 indicated rapid and complete drug release for whole valbenazine capsules and crushed capsule contents, with similar release at 10 minutes (whole, 94%-99%; crushed, 98%-100%) and 60 minutes (whole, 101%-103%; crushed, 101%-102%). Study 2 found acceptable valbenazine recovery within 2 hours of adding crushed capsule contents to tested foods, buffers, or fed-state simulated gastric fluid (recovery, 92%-102%). Study 3 found acceptable valbenazine recovery when crushed contents were added to cold or hot water and delivered via G-tube, with a water cup rinse to capture residual contents (recovery, 91%-97%). IMPLICATIONS These studies indicate the potential viability of valbenazine formulation(s) that can be added to soft foods or liquids or delivered via G-tube. Such formulations will be important for individuals who require treatment with a vesicular monoamine transporter 2 inhibitor but cannot swallow whole pills.
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Affiliation(s)
- Martha Sajatovic
- Case Western Reserve University School of Medicine, Cleveland, Ohio; Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
| | - Amita Patel
- Institute for Psychiatric Education, Dayton, Ohio
| | - Mello Hebert
- Neurocrine Biosciences Inc, San Diego, California
| | | | | | - Ali Bristow
- Neurocrine Biosciences Inc, San Diego, California
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Malouh MA, Sefidani Forough A, Cichero JAY, Lau ETL, Nissen LM, Steadman KJ. The prevalence and perceived effectiveness of using a medication-swallowing lubricant in aged care facilities across Australia. Aging Med (Milton) 2023; 6:239-244. [PMID: 37711253 PMCID: PMC10498827 DOI: 10.1002/agm2.12261] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/15/2023] [Accepted: 06/18/2023] [Indexed: 09/16/2023] Open
Abstract
Objective To explore the extent of use and perceived effectiveness of using a medication lubricant that is specifically designed to help people who struggle to swallow their solid medications whole. Method Health care workers of varying professional levels in aged care facilities (ACFs) across Australia who are involved in medication administration were invited to participate in a structured online survey. Results Of the 355 health care workers who completed the survey, 48% had used the medication lubricant to aid administration of whole and/or crushed solid oral dosage forms, and of these 89% agreed with the statement that "it is effective method to facilitate medication swallowing in residents." The main benefits of using the medication lubricant were considered to be easier medication administration to residents (49%), reduction in need for crushing of medications (34%), and better adherence with medications (33%). Conclusions This study showed that using a medication lubricant for aged care residents may facilitate the process of medication administration for health care workers, which they perceive to improve residents' adherence with medications. Serious complications associated with solid dosage form modification may also be decreased by using a medication lubricant, as the need for modifying medications is reduced. Therapeutic Goods Administration (TGA)-approved medication lubricants could therefore be a valuable tool to aid the medication administration for patients who have difficulties swallowing medications. Future research may consider the clinical efficacy and acceptability of medication lubricants specifically for people with swallowing difficulties.
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Affiliation(s)
- Marwa A. Malouh
- School of PharmacyThe University of QueenslandBrisbaneQueenslandAustralia
| | - Aida Sefidani Forough
- School of Clinical SciencesQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Julie A. Y. Cichero
- School of PharmacyThe University of QueenslandBrisbaneQueenslandAustralia
- School of Clinical SciencesQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Esther T. L. Lau
- School of PharmacyThe University of QueenslandBrisbaneQueenslandAustralia
- School of Clinical SciencesQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Lisa M. Nissen
- School of PharmacyThe University of QueenslandBrisbaneQueenslandAustralia
- School of Clinical SciencesQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Kathryn J. Steadman
- School of PharmacyThe University of QueenslandBrisbaneQueenslandAustralia
- School of Clinical SciencesQueensland University of TechnologyBrisbaneQueenslandAustralia
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5
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Hummler H, Sarwinska D, Weitschies W, Gollasch M, Page S. Parameters to Consider for Successful Medication Use in Older Adults - an AGePOP Review. Eur J Pharm Sci 2023:106453. [PMID: 37149104 DOI: 10.1016/j.ejps.2023.106453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/27/2023] [Accepted: 04/24/2023] [Indexed: 05/08/2023]
Abstract
Older adults are the main users of medicine and due to their multimorbidity are often faced/confronted with a complex medication management. This review article provides a brief overview on aspects of medication management such as maintaining a stock of the required medicine, understanding and following the instructions for use, coping with the primary and secondary packaging as well as preparation prior to use. The main focus however is on the drug intake itself and provides an overview about the current understanding of real life dosing conditions of older adults and geriatric patients. Furthermore, it elaborates the acceptability of dosage forms, in particular solid oral dosage forms as they represent the majority of dosage forms taken by these patient populations. An improved understanding of the needs of older adults and geriatric patients, their acceptability of various dosage forms and the circumstances under which they manage their medications, will make the design of more patient-centric drug products possible.
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Affiliation(s)
- Henriette Hummler
- Pharma Technical Development, F. Hoffmann-La Roche Ltd., Grenzacher Str. 124, CH-4070, Basel, Switzerland
| | - Dorota Sarwinska
- Center of Drug Absorption and Transport, Department of Biopharmaceutics and Pharmaceutical Technology, Institute of Pharmacy, University of Greifswald, Felix-Hausdorff-Str. 3, 17489, Greifswald, Germany
| | - Werner Weitschies
- Center of Drug Absorption and Transport, Department of Biopharmaceutics and Pharmaceutical Technology, Institute of Pharmacy, University of Greifswald, Felix-Hausdorff-Str. 3, 17489, Greifswald, Germany
| | - Maik Gollasch
- Department of Internal Medicine and Geriatrics, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Susanne Page
- Pharma Technical Development, F. Hoffmann-La Roche Ltd., Grenzacher Str. 124, CH-4070, Basel, Switzerland.
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Lee SV, Aplin T, Sefidani Forough A, Steadman KJ. Perceived Usability of Tablet Crushers: Comparison of Devices by People with and without Limited Hand Functions. Pharmaceutics 2023; 15:pharmaceutics15020517. [PMID: 36839840 PMCID: PMC9961238 DOI: 10.3390/pharmaceutics15020517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
Tablet crushing is a common practice used by patients and their carers, mainly to facilitate swallowing. Various tablet-crushing devices with different designs are currently available on the market. This study aimed to compare the usability of different tablet-crushing devices in people with and without limited hand functions. The hand function of 100 adults recruited from the general community (40 of whom self-reported a limited hand function) was assessed using the hand and finger function subscale of the Arthritis Impact Measurement Scale version 2. The hand strength was measured using a dynamometer. Participants crushed tablets using 11 crushing devices and completed a Rapid Assessment of Product Usability and Universal Design questionnaire for each device. Hand-held twist-action crushers with an ergonomic grip received the highest usability scores among both groups, irrespective of the cost (p < 0.05). Crushers with bags were scored lower by those with limited hand functions, although the score improved if the device was automatic. Preferences regarding electronic crushers significantly changed once the cost was revealed. Economical twist-action crushers with ergonomic grips and without bags or cups were the most favoured crushers.
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Affiliation(s)
- Su Vin Lee
- School of Pharmacy, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Tammy Aplin
- School of Rehabilitation Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, QLD 4032, Australia
| | - Aida Sefidani Forough
- School of Clinical Sciences, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Kathryn J. Steadman
- School of Pharmacy, The University of Queensland, Brisbane, QLD 4072, Australia
- Correspondence:
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Lim CX, Livesay K, Stevens J, Nooney V, Baverstock K, Orwin N, Stupans I. Dosage Form Modification, a Simulation Activity between Nursing and Pharmacy Students. PHARMACY 2022; 10:pharmacy10060141. [PMID: 36412817 PMCID: PMC9680216 DOI: 10.3390/pharmacy10060141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/17/2022] [Accepted: 10/25/2022] [Indexed: 12/14/2022] Open
Abstract
Background: The aim of this exploratory pilot study was to evaluate student perceptions of a simulation activity involving undergraduate nursing and pharmacy students. The key question was "how do nursing and pharmacy students respond in an immersive collaborative simulation activity which involves medication dosage form modification?" Methods: One hundred nursing students participated in a simulated exercise where patients required medications for which there were barriers to administration. Fourteen pharmacy students were also present in the simulated health environment, observing the work of the nursing students and being available to provide advice regarding medication administration to the nursing students. A mixed methods approach was employed for this exploratory pilot study, where both nursing and pharmacy students were invited to complete a survey regarding the experience at the end of the simulation exercise and pharmacy students completed a reflection. Both surveys and reflections were analyzed. Results: Survey results indicated very high satisfaction regarding the exercise for both pharmacy and nursing students. Analysis of pharmacy student reflections also indicated apprehension regarding their preparedness to contribute to the exercise, enjoyment in participation, their understanding of the value of collaboration between the two groups of students, and also recognition of their need to be more prepared for such situations. Conclusion: This study assessed student perceptions and did not formally evaluate learning outcomes. The interprofessional immersive simulated learning opportunity was viewed as valuable by both nursing and pharmacy students. The immersive simulation provided teaching staff with the opportunity to develop a new approach for the teaching of dosage form modification to both nursing and pharmacy students in an interprofessional setting.
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Affiliation(s)
- Chiao Xin Lim
- Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC 3000, Australia
- Correspondence:
| | - Karen Livesay
- Nursing, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC 3000, Australia
| | - Julie Stevens
- Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC 3000, Australia
- Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
| | - Vivek Nooney
- Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC 3000, Australia
| | - Katherine Baverstock
- Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC 3000, Australia
| | - Nichole Orwin
- Nursing, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC 3000, Australia
| | - Ieva Stupans
- Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC 3000, Australia
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8
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Solberg H, Devik SA, Bell HT, Olsen RM. The art of making the right exception to the "rule": Nurses' experiences with drug dispensing in nursing homes. Geriatr Nurs 2022; 44:229-236. [PMID: 35240402 DOI: 10.1016/j.gerinurse.2022.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/12/2022] [Accepted: 02/15/2022] [Indexed: 11/25/2022]
Abstract
Nurses are key professionals in ensuring safe drug management in nursing homes, and their practice is regulated by a number of guidelines. The present study aimed to explore nurses' experiences of dispensing drugs to older people in nursing homes by using an exploratory qualitative design. Focus group interviews were conducted in three nursing homes in central Norway; the data were analyzed using qualitative content analysis. The results indicated that drug dispensing was perceived as a complicated process during which both anticipated and unforeseen challenges arose that influenced the nurses' abilities to follow professional standards. In these situations, the nurses had to apply their knowledge and make various adjustments based on conditions in the organization and the needs of individual patients. The findings have implications for facilitating nurses' working conditions and resources to avoid drug administration that limit the discretion of nurses and threaten patient safety in nursing homes.
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Affiliation(s)
- Hege Solberg
- Faculty of Nursing and Health Sciences, Nord University, PO Box 474, 7801 Namsos Norway.
| | - Siri Andreassen Devik
- Centre for Care Research Mid-Norway, Faculty of Nursing and Health Sciences, Nord University, PO Box 474, 7801 Namsos, Norway
| | - Hege Therese Bell
- Trondheim municipality, Erling Skakkes gate 14, 7013 Trondheim, Norway; Master in Pharmacy, Department of clinical and molecular medicine, Norwegian University of Science and Technology, Høgskoleringen, 1, 7491, Trondheim, Norway
| | - Rose Mari Olsen
- Centre for Care Research Mid-Norway, Faculty of Nursing and Health Sciences, Nord University, PO Box 474, 7801 Namsos, Norway
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9
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Atkins B, Bhattacharya D, Smith C, Scott S. Barriers and enablers to switching from a solid to a liquid formulation of Parkinson's medication: a theory-based mixed methods investigation. Int J Clin Pharm 2022; 44:1046-1056. [PMID: 35842516 PMCID: PMC9393141 DOI: 10.1007/s11096-022-01446-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/12/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Swallowing tablets/capsules can become difficult and dangerous for People with Parkinson's (PwP) who develop oropharyngeal dysphagia. Switching to a liquid delays the need for progressing to last line patches/injections. However, liquids are rarely used therefore a change in prescribing practice is warranted but, as with any change in behaviour, may be met with resistance. AIM To characterise PwPs and carers' barriers and enablers (determinants) of switching from solid to liquid Parkinson's medication formulations. METHOD Underpinned by the Theoretical Domains Framework, focus groups with PwPs and carers were convened to identify determinants of switching, which were then used to develop a questionnaire distributed across the UK. Determinants were prioritised if ≥ 50% of respondents agreed/strongly agreed that they were important to their decision to switch to a liquid formulation. Percentage precisions were reported as 95% confidence intervals. RESULTS From three focus groups and 131 questionnaires responses, PwPs and carers prioritised nine determinants. Three enablers had almost unanimous agreement: liquids' flexibility for incremental dosing (72% ± 8); decline in Parkinson's control (72% ± 8); prescriber's endorsement to switch (70% ± 8). The barriers: perception that tablets/capsules are easier to dose than liquids (72% ± 8); and prescriber's opposition to switching (70% ± 8), attracted similarly high agreement. CONCLUSION There is a desire to switch to liquids when Parkinson's progresses and for their use beyond this to offer flexibility in dosing, a previously unrecognised indication for switching. The only notable resistance to switching may be addressed by innovations from the pharmaceutical industry to make liquids easier to measure.
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Affiliation(s)
- Bethany Atkins
- School of Allied Health Professions, University of Leicester, Leicestershire, LE1 7RH UK
| | - Debi Bhattacharya
- School of Allied Health Professions, University of Leicester, Leicestershire, LE1 7RH UK
| | - Caroline Smith
- School of Allied Health Professions, University of Leicester, Leicestershire, LE1 7RH UK
| | - Sion Scott
- School of Allied Health Professions, University of Leicester, Leicestershire, LE1 7RH, UK.
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Robert V, Fabri B, Bouillot E, Papailhau C, Abbes M, Grino M, Vincentelli MB. A description of dry oral forms of medication administration modifications by nurses in home settings. Geriatr Nurs 2021; 43:249-253. [PMID: 34952308 DOI: 10.1016/j.gerinurse.2021.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 11/15/2022]
Abstract
Modifying the galenic of dry oral forms (DOF) to be administered to patients with swallowing or behavioral disorders is frequent in long term care homes. The objective was to investigate the practice of modifying DOF galenic by nurses in home settings (NHS). A 14-question electronic survey was distributed to 1977 NHS. Almost 3/4 of respondents reported crushing tablets or opening capsules, with 37% on a daily basis. Approximately 22% did not inquire about the feasibility of modifying galenic DOF beforehand. Nearly 75% of NHS were aware about the risk of ineffectiveness after crushing tablets or opening capsules. However, only 14% mentioned the risk of overdosing associated with this practice. More than 60% of NHS never wore protective equipment when changing dosage form. Changing the dosage form of DOF is a widespread practice in home settings. Our present work urges the need to improve collaboration between prescribing physicians, nurses and pharmacists.
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Affiliation(s)
- Vincent Robert
- Internal Pharmacy Department, State Geriatric Center, 176 avenue de Montolivet, Marseille 13012, France.
| | - Benjamin Fabri
- Internal Pharmacy Department, State Geriatric Center, 176 avenue de Montolivet, Marseille 13012, France
| | - Elodie Bouillot
- Internal Pharmacy Department, State Geriatric Center, 176 avenue de Montolivet, Marseille 13012, France
| | - Charlotte Papailhau
- Internal Pharmacy Department, State Geriatric Center, 176 avenue de Montolivet, Marseille 13012, France
| | - Mélissa Abbes
- Internal Pharmacy Department, State Geriatric Center, 176 avenue de Montolivet, Marseille 13012, France
| | - Michel Grino
- Department of Clinical Research, State Geriatric Center, Marseille, France
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Strauss M, Mičetić-Turk D, Pogačar MŠ, Fijan S. Probiotics for the Prevention of Acute Respiratory-Tract Infections in Older People: Systematic Review. Healthcare (Basel) 2021; 9:690. [PMID: 34200435 PMCID: PMC8228160 DOI: 10.3390/healthcare9060690] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/29/2021] [Accepted: 06/02/2021] [Indexed: 01/14/2023] Open
Abstract
The aim of this systematic review was to present the indirect influence of probiotics on the incidence and duration of acute upper respiratory-tract infections in older people, by regulating the immune system. Eight randomized, placebo-controlled clinical trials met the inclusion criteria, considering the threshold of older people being 60 years and over. Single strain probiotics were used in all studies, including three probiotic strains used in fermented foods: Lactobacillus delbrueckii subsp. bulgaricus OLL1073R-1, Lacticaseibacillus paracasei subsp. paracasei CNCM I-1518 and Lacticaseibacillusparacasei Shirota, and three probiotic strains used as food supplements: Loigolactobacillus coryniformis K8 CECT5711, Bacillus subtilis CU1 and Lacticaseibacillus rhamnosus GG. Current evidence showed that certain probiotic strains were better than a placebo in lowering the incidence or number of older people experiencing acute upper respiratory tract infections; however, not all probiotic strains were efficient, and not all studies reported statistically significant outcomes. More high quality large-scale properly controlled clinical studies focusing on older people are warranted.
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Affiliation(s)
- Maja Strauss
- Faculty of Health Sciences, Institute for Health and Nutrition, University of Maribor, Žitna ulica 15, 2000 Maribor, Slovenia; (M.S.); (D.M.-T.)
| | - Dušanka Mičetić-Turk
- Faculty of Health Sciences, Institute for Health and Nutrition, University of Maribor, Žitna ulica 15, 2000 Maribor, Slovenia; (M.S.); (D.M.-T.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia;
| | - Maja Šikić Pogačar
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia;
| | - Sabina Fijan
- Faculty of Health Sciences, Institute for Health and Nutrition, University of Maribor, Žitna ulica 15, 2000 Maribor, Slovenia; (M.S.); (D.M.-T.)
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12
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Abstract
Taking oral solid dosage forms (OSDFs) safely and effectively is particularly important. This study aimed to determine the pattern and knowledge about the proper criteria of OSDF administration and the consumers’ preferences toward OSDF characteristics. The aims of this study were achieved by cross-sectional survey through open and closed-ended questionnaires, and the presence of the main OSDF administration recommendations of a sample of 32 OSDF drug leaflets was assessed. Based on a simple random sample of 250 volunteers, we found inadequate compliance with the OSDF medicine administration criteria. We also found an absence of the main recommendations of OSDF drug administration on most of the investigated OSDF drug leaflets. Conventional white, round tablets were found to be the most preferred type of OSDF drug. These findings can be valuable to pharmaceutical manufacturers, regulatory agencies, and pharmacists to enhancing patient awareness and compliance with OSDF administration for safe and effective drug administration.
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Solberg H, Devik SA, Bell HT, Zeiss DH, Olsen RM. Drug modification by nurses in Norwegian nursing homes: A cross-sectional study. Geriatr Nurs 2021; 42:351-357. [PMID: 33561616 DOI: 10.1016/j.gerinurse.2021.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
Crushing and dividing pills among older patients in nursing homes appears to be a common yet not harmless practice. Because few updates exist regarding the role of nurses and their dispensing of drugs in nursing homes, this study sought to describe the occurrence, methods, and causes of nurses' drug modification and to examine possible factors associated with drug modification in this context. A cross-sectional study of 273 dispensing episodes of solid oral drugs made by nurses, were observed during day and evening shifts. Modifications were made in 20.5% of the dispensing episodes, including 80.4% where alterations were made by crushing and 19.6% where alterations were made dividing. The most commonly reported reasons for modification were 'swallowing difficulties' (53.6%) and 'lack of understanding by the patient' (19.6%). The logistic regression analysis showed a significant association between the occurrence of drug modification and both cognitive impairment and administration method.
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Affiliation(s)
- Hege Solberg
- Faculty of Nursing and Health Sciences, Nord University, PO Box 474, 7801 Namsos Norway.
| | - Siri Andreassen Devik
- Centre for Care Research Mid-Norway, Nord University, PO Box 474, 7801 Namsos, Norway
| | - Hege Therese Bell
- Faculty of Nursing and Health Sciences, Nord University, PO Box 474, 7801 Namsos Norway; Faculty of Nursing and Health Sciences, Nord University, PO Box 93, 760 Levanger, Norway; Master in Pharmacy, Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Høgskoleringen, 1, 7491 Trondheim, Norway
| | - Daniel Horst Zeiss
- Faculty of Nursing and Health Sciences, Nord University, PO Box 474, 7801 Namsos Norway
| | - Rose Mari Olsen
- Faculty of Nursing and Health Sciences, Nord University, PO Box 474, 7801 Namsos Norway
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Radhakrishnan C, Sefidani Forough A, Cichero JAY, Smyth HE, Raidhan A, Nissen LM, Steadman KJ. A Difficult Pill to Swallow: An Investigation of the Factors Associated with Medication Swallowing Difficulties. Patient Prefer Adherence 2021; 15:29-40. [PMID: 33469272 PMCID: PMC7810703 DOI: 10.2147/ppa.s277238] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 12/22/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Many medications are available as solid oral dosage forms such as tablets and capsules; however, some people find these medications difficult to swallow. AIM To identify whether certain psychological, oral sensory, and oral motor characteristics contribute to medication swallowing difficulties. METHODS A sample of healthy adults from two academic institutions in Brisbane were assessed for their experiences with swallowing solid oral dosage forms, food preferences, and food neophobia. The gag reflex, oral cavity size, fungiform papillae count, and chewing efficacy were also evaluated followed by a capsule-swallowing task. Primary outcome was the incidence of medication swallowing difficulties. Secondary outcomes were the association of medication swallowing difficulties with psychological, oral sensory, and oral motor factors. RESULTS Of 152 subjects, 32% reported difficulty swallowing tablets or capsules whole. This group was significantly more likely to have had a memory of choking on medications compared to those without medication swallowing difficulties (OR = 7.25, p < 0.05). Current medication swallowing difficulties were significantly associated with a smaller mouth cavity size (OR = 2.98, p < 0.05), a higher density of taste receptors on the tongue (OR = 3.27, p < 0.05), and were higher among those who chewed a jelly candy to non-homogenous particle size (OR = 4.1, p < 0.05). Current medication swallowing difficulties were associated with lower confidence in swallowing large capsules (000 size: OR = 0.47, 00 size: OR = 0.39, p < 0.05). No associations were found between medication swallowing difficulties and the gag reflex or food neophobia. CONCLUSION A combination of heightened oral perception characterized by a small oral cavity and high taste sensitivity compounded by a past choking episode on medications may be precipitating factors for medication swallowing difficulties. These factors may be helpful in identifying individuals who are more likely to experience difficulty swallowing medications.
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Affiliation(s)
| | - Aida Sefidani Forough
- School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Julie A Y Cichero
- School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia
- School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Heather E Smyth
- Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, Centre for Nutrition and Food Sciences, Brisbane, Queensland, Australia
| | - Aisha Raidhan
- Department of Pharmacy, King’s College London, London, UK
| | - Lisa M Nissen
- School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia
- School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Kathryn J Steadman
- School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia
- School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- Correspondence: Kathryn J Steadman Tel +61 7 334 61886Fax +61 7 3346 1999 Email
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Sefidani Forough A, Lau ETL, Steadman KJ, Kyle GJ, Cichero JAY, Serrano Santos JM, Nissen LM. Factors that affect health-care workers' practices of medication administration to aged care residents with swallowing difficulties: An Australia-wide survey study. Australas J Ageing 2020; 40:e79-e86. [PMID: 32985061 DOI: 10.1111/ajag.12856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 08/15/2020] [Accepted: 08/16/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To understand the barriers and facilitators of medication administration to aged care residents with swallowing difficulties. METHODS Health-care workers in aged care facilities across Australia involved in medication administration to residents completed an online survey. RESULTS Of 355 respondents, 90.9% reported 'everyday' encounters with residents with swallowing difficulties and 94.1% modified medications to facilitate administration. Time constraints (63.4%) and workload (69.0%) were common barriers. Only 39.0% believed swallowing abilities are considered at the prescribing stage. Pill size (95.8%), polypharmacy (75.2%) and lack of alternative formulations (74.9%) contributed to these challenges. Support from other health-care professionals (91.5%) and training (85.9%) were the most favoured facilitators. CONCLUSION Health-care workers are faced with various challenges when caring for residents with swallowing difficulties. Promoting multidisciplinary collaborations, provision of training and medication review services, and improving skill mix and staffing composition in aged care facilities are needed to address these challenges.
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Affiliation(s)
- Aida Sefidani Forough
- Discipline of Pharmacy, Faculty of Health, School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Qld, Australia
| | - Esther T L Lau
- Discipline of Pharmacy, Faculty of Health, School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Qld, Australia.,School of Pharmacy, The University of Queensland, Brisbane, Qld, Australia
| | - Kathryn J Steadman
- Discipline of Pharmacy, Faculty of Health, School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Qld, Australia.,School of Pharmacy, The University of Queensland, Brisbane, Qld, Australia
| | - Greg J Kyle
- Discipline of Pharmacy, Faculty of Health, School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Qld, Australia
| | - Julie A Y Cichero
- Discipline of Pharmacy, Faculty of Health, School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Qld, Australia.,School of Pharmacy, The University of Queensland, Brisbane, Qld, Australia
| | - Jose Manuel Serrano Santos
- Discipline of Pharmacy, Faculty of Health, School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Qld, Australia
| | - Lisa M Nissen
- Discipline of Pharmacy, Faculty of Health, School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Qld, Australia.,School of Pharmacy, The University of Queensland, Brisbane, Qld, Australia
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