Aim To identify opinions and experiences of participants regarding liquids and tablets.
Method A single-site (specialised paediatric hospital), cross-sectional study was conducted through use of pre-piloted semi-structured interviews with parents or carers of children aged between two and 11 years. The target cohort was modified to reflect sampling issues encountered in the pilot study. Consequently, patients participating in the study were divided into two categories; group one were taking tablets (n=10, age range 2–11 years (<6 years: n=4)) and group two were taking other oral dosage forms (n=10, age range 2–9 years (<6 years: n=8)). Participants were identified by examination of individual in-patient drug charts and handover sheets to determine patient demographics and prescribed formulations. Interviews were conducted with parents or carers (group one: n=12; group two: n=13) and patients where appropriate. Results were coded and sub-coded using Microsoft word to systematically analyse arising themes.
Results Liquids were discovered as the most widely used oral formulation in study patients (n=19). Thirteen patients had experience with taking tablets, five of which were positive experiences. Only three of these five patients were able to swallow tablets whole and unaided. These patients learned at ages four, five and 10 years, using food and liquids to aid swallowing. Four patients suffered with tablet swallowing difficulties, three of which refused to take tablets. A total of 10 patients had never swallowed tablets whole (aged 2–9 years). Other barriers to tablet swallowing were identified as fears of choking, tablet taste and age of patients. The majority of patients preferred liquids (n=18) and most parents and carers also preferred liquids (n=15). Nearly all participants (n=16) believed tablets were useful formulations for children, referring to their ease of use and convenience. Parent-carer experiences with tablets were generally positive and no similarities between parent and child responses to tablets were found. A large number of parent-carers (n=18) believed it was beneficial to teach children to swallow tablets and most (n=19) were willing to use a training method for tablet swallowing if there was sufficient evidence it was successful. Few participants were aware of training methods which had been reported in previous studies; modelling (n=1) and grading (n=1).1
Conclusion Increased age did not signify better experience with tablets despite parents and carers believing that older children were more suited to tablets. Although it was noted that tablets were more likely to be attempted in older children when they possessed greater knowledge and understanding, liquids were favoured by parents and children across both study groups. The lack of awareness of training methods for tablet swallowing, in combination with the vast interest in using a training method, indicated the potential use of such methods in children with non-physical swallowing difficulties.2
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