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’).¹ Through 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).^3,4 Post-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

1. Tse Y, Vasey N, Dua D, et al. The KidzMed project: teaching children to swallow tablet medication. Arch Dis Child 2020;105:1105-1107.

2. 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.

3. 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.

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