Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Dysphagia
Published in: Dysphagia 1/2009

01-03-2009 | Original Article

A Qualitative Study of the Problems Surrounding Medicine Administration to Patients with Dysphagia

Authors: Jennifer Kelly, Gibson D’Cruz, David Wright

Published in: Dysphagia | Issue 1/2009

Login to get access

Abstract

Swallowing dysfunction in the elderly is common and affects not only nutrition but also the ingestion of medicines. This qualitative study used a focus group to collect data from ten healthcare professionals who are involved in the care of people with swallowing difficulties. The group discussed their experiences of the problems associated with and solutions to the administration of medicines to patients with dysphagia. The focus group was audiotaped, and the data analysed using Colaizzi’s technique. Six themes were identified, three main ones: (1) the wide spectrum of dysphagia; (2) medicine formulation, which affects how drugs can be administered; (3) problems with data flow, i.e., the correct information being with the right person at the right time and in the right place; and three minor ones which arose from the major themes: (4) the primary function of swallowing is nutrition rather than taking medication; (5) cost of medicines; and (6) therapeutic dilemmas. The study concludes that improvements in interprofessional communication are needed to improve medicine administration to dysphagic patients.
Literature
1.
Lindgren S, Janzon L. Prevalence of swallowing complaints and clinical findings among 50–79-year-old men and women in an urban population. Dysphagia. 1991;6:187–92PubMedCrossRef
2.
Steele C, Caslpo R, Greenwood C, Ens I, Robertson C, Seidman-Carlson R. Mealtime difficulties in a home for the aged: not just dysphagia. Dysphagia. 1997;12:45–50CrossRef
3.
Carnaby-Mann G, Crary M. Pill swallowing by adults with dysphagia. Arch Otolaryngol Head Neck Surg. 2005;313:970–5CrossRef
4.
Society for the Advancement of Education, Swallowing difficulties cause for concern. USA Today, 2004, October, p.14
5.
McGavok H. How drugs work. Basic pharmacology for healthcare professionals, 2nd ed. Oxford: Radcliffe Publishing; 2005
6.
Preston M, Morris H. Dysphagia, the impact on dispensing doctors. Dispensing Doctor J. 2005;21:11–5
7.
Andersen O, Zweidorff O, Hjelde T, Rodland E. Problems when swallowing tablets. A questionnaire study from general practice. Tidsskr Nor Laegeforen. 1995;115:947–9PubMed
8.
Strachan I, Greener M. Medication-related swallowing difficulties may be more common than we realise. Pharmacy in Practice. 2005; 411–414
9.
White R, Bradnam V (eds). Handbook of Drug Administration via Enteral Feeding Tubes. London: BPNG; 2006
10.
Elia M. Trends in artificial nutrition support in the UK during 1996–2000. Redditch: British Association of Enteral and Parenteral Nutrition; 2001
11.
Beckwith MC, Feddema SS, Barton RG, Graves C. A Guide to Drug Therapy in Patients with Enteral Feeding Tubes: Dosage Form Selection and Administration Methods. Hospital Pharmacy. 2004;39:225–37
12.
Mistry B, Samuel S, Bowden S, McArtney R, Roberts D. Simplifying oral drug therapy for patients with swallowing difficulties. Pharm J. 1995;254:808–9
13.
Belknap D, Seifert C, Petermann M. Administration of medications through enteral feeding catheters. Am J Crit Care. 1997;6:382–92PubMed
14.
Tissot E, Cornette C, Demoly P, Jacquet M, Barale F, Capellier G. Medication errors at the administration stage in an intensive care unit. Intensive Care Med. 1999;25:353–9PubMedCrossRef
15.
Wright D. Medication administration in nursing homes. Nurs Stand. 2002;16:33–8PubMed
16.
Kirkevold O, Engedal K. Concealment of drugs in food and beverages in nursing homes: cross sectional study. BMJ. 2005;330:20–2PubMedCrossRef
17.
Royal Pharmaceutical Society of Great Britain. Fitness to practice and legal affairs directorate fact sheet 5. The use of unlicensed medicines in pharmacy. London: Royal Pharmaceutical Society of Great Britain; 2004
18.
Wright D. Swallowing difficulties protocol: medication administration. Nurs Stand. 2002;17:43–5PubMed
19.
Griffith R, Davies R. Accountability and drug administration in community care. Br J Commun Nurs. 2003;8:65–9
20.
Griffith R. Managing difficulties in swallowing solid medication: the need for caution. Nurse Prescriber. 2005;3:201–3
21.
Thomson F, Naysmith M, Lindsay A. Managing drug therapy in patients receiving enteral and parenteral nutrition. Hospital Pharmacist. 2000;7:155–64
22.
23.
Miller D, Miller H. Giving meds through the tube. RN 1995; 44–46
24.
Adams D. Administration of drugs through a jejunostomy tube. An overview of compatibility and efficacy. Br J Intensive Care. 1994;4:10–7
25.
Barnes L, Cheek J, Nation R, Gilbert A, Paradiso L, Ballantyne A. Making sure the residents get their tablets: medication administration in care homes for older people. J Adv Nurs. 2006;56:190–9PubMedCrossRef
26.
Kitzinger J. Focus group research: using group dynamics to explore perceptions, experiences and understandings. In: Holloway I, editor. Qualitative Research in Health Care. Maidenhead: Open University Press; 2005 p. 56–69
27.
Morgan D. Focus groups as qualitative research, 2nd ed. London: Sage Publications; 1997
28.
Gobo G. Sampling, representativeness, generalizability. In: Seale C, Gobo G, Gubrium J, Silverman D, editors. Qualitative Research Practice. London: Sage; 2004
29.
Colaizzi P. Psychological research as the phenomenologist views it. In: Valle R, King M, editors, Existential phenomenological alternatives for psychology. Oxford: Oxford University Press; 1978
30.
Polit D, Beck C. Essentials of Nursing Research. Methods, Appraisal and Utilisation, 6th ed. Philadelphia: Lippincott, Williams & Wilkins; 2005
31.
Murray T, Carrau R. Clinical Management of Swallowing Disorders, 2nd ed. Oxford: Plural Publishing; 2006
32.
Smithard D, O’Nell P, England R, Park C, Wyatt R, Martin D, et al. The natural history of dysphagia following a stroke. Dysphagia. 1997;12:188–93PubMedCrossRef
33.
Bloem B, Lagaay A, van Beek W, Haan J, Roos R, Wintzen A. Prevalence of subjective dysphagia in community residents aged over 87. BMJ. 1990;300:721–2PubMed
34.
Wright D. GPs should ask about swallowing difficulties when prescribing. Guidelines in Practice. 2007;10:19–24
35.
Taylor D, Helliwell M. Liquid preparations for oral administration. Prof Nurse. 1992;8:163–6PubMed
36.
Smyth J (ed). The NEWT guidelines for administration of medication to patients with enteral feeding tubes or swallowing difficulties. Wrexham: North East Wales NHS Trust; 2006
37.
Woolfrey S, Geddes A, Hussain A, Cox J. Percutaneous endoscopic gastrostomy. Pharm J. 1996;257:181–4
38.
Paradiso L, Roughead E, Gilbert A, Cosh D, Nation R, Barnes L, et al. Crushing or altering medications: what’s happening in residential aged-care facilities? Australas J Ageing. 2002;21:123–7CrossRef
39.
Simpson C. Crushed medications: an emerging guideline. Aust Nurs J. 2005;13:1–3
40.
Winnick S, Lucas D, Hartman A, Toll D. How do you improve compliance? Pediatrics. 2005;115:78–724CrossRef
41.
Pelletier C, Dhanaraj G. The effect of taste and palatability on lingual swallowing pressure. Dysphagia. 2006;21:121–8PubMedCrossRef
42.
Martin T, Hayes P, Collins D. Tablet dispersion as an alternative to formulation of oral liquid dosage forms. Aust J Hosp Pharm. 1993;23:378–86
43.
Jordan S. Adverse drug reactions: reducing the burden of treatment. Nurs Stand. 2007;21:35–41PubMed
44.
45.
Dean B, Schachter M, Vincent C, Barber N. Causes of prescribing errors in hospital inpatients: a prospective study. Lancet. 2002;359:1373–8PubMedCrossRef
46.
Griffith R, Davies R. Tablet crushing and the law: the implications for nursing. Prof Nurse. 2003;19:41–2PubMed
47.
Griffith R. Tablet crushing and the law. Pharm J. 2003;271:90–1
48.
Schell K. Compliance issues and extemporaneous preparation of medications for pediatric patients. J Pharm Technol. 1992;8:158–61PubMed
49.
50.
Treloar A, Beats B, Philpot M. A pill in the sandwich: covert medication in food and drink. J R Soc Med. 2000;93:408–11PubMed
51.
Kirkevold O, Engedal K. Concealment of drugs in food and beverages in nursing homes: cross sectional study. BMJ. 2004;330:20–3PubMedCrossRef
52.
53.
British Medical Association and Royal Pharmaceutical Society of Great Britain. British National Formulary 53. London: BMJ Publishing; 2007
54.
Beauchamp T, Childress J. Principles of Biomedical Ethics, 5th ed. Oxford: Oxford University Press, 2001
55.
Cornish P. “Avoid the crush”: hazards of medication administration in dysphagia or a feeding tube. Can Med Assoc J. 2005;172:871–2CrossRef
56.
Wright D, Chapman N, Foundling-Miah M, Greenwall R, Griffith R, Guyon A, et al. Consensus guidelines on the medication management of adults with swallowing difficulties. Berkhamsted: Medenium Group Publishing; 2006
57.
Fair R, Proctor B. Administration of medicines through enteral feeding tubes, 2nd ed. Belfast: The Royal Hospitals; 2005
Metadata
Title
A Qualitative Study of the Problems Surrounding Medicine Administration to Patients with Dysphagia
Authors
Jennifer Kelly
Gibson D’Cruz
David Wright
Publication date
01-03-2009
Publisher
Springer-Verlag
Published in
Dysphagia / Issue 1/2009
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-008-9170-3

Other articles of this Issue 1/2009

Dysphagia 1/2009 Go to the issue

Case Report

Dysphagia Due to Unilateral Infarction in the Vascular Territory of the Anterior Insula

Original Article

Differences in Tongue Strength Across Age and Gender: Is There a Diminished Strength Reserve?

Original Article

Cross-cultural Adaptation and Validation of the Dutch Version of SWAL-QoL

Letter

People with a Learning Disability and Dysphagia: A Cinderella Population?

Original Article

Prevalence of Perceived Dysphagia and Quality-of-Life Impairment in a Geriatric Population

Original Article

An In Vitro Model for Studying Neuromuscular Transmission in the Mouse Pharynx