Difficulty in taking medication for patients with neurological diseases
2017 Volume 34 Issue 2 Pages 112-116
Details
2017 Volume 34 Issue 2 Pages 112-116
Purpose : Difficulty in taking medications results in inaccurate judgments regarding the effects of treatment with oral medication and impairs medication adherence. We investigated the present situation with regard to difficulty in taking medications for patients with neurological diseases.
Methods : Difficulty in taking medication was defined as cases in which a patient experienced difficulty swallowing or had to swallow three or more times, had to wash the medication down with water or jelly, choked on drugs, had drug residue or a feeling of residue in the oral cavity, pharynx, or esophagus, or coughed up drugs, or had drug residue around the mouth. We examined patients ≥65 years old with neurological diseases from 26 facilities who were deemed to have difficulty taking medication by a medical professional specializing in dysphagia. As adhesion experiment of drug to review the association of drug residue and pharmaceutical adherence, a total of 0.3ml of water was dropped onto the drug placed on a cellulose acetate film sheet.
Results : This study identified 136 patients with difficulties taking medication. Medication was self–administered in 27% of patients, regular meals of a non–modified diet were consumed by 34% of patients, and swallowing screening tests yielded normal results in 33% of patients. Drug residue was seen in the oral cavity or pharynx in any dosage form in 55% of patients. In adhesion experiments, water was dropped on to five dosage forms of drugs, sugar–coated tablets have the lowest adhesiveness, strong adhesion with film tablet, orally disintegrating tablets, film–coated tablets, and uncoated tablets. In seven types of generic orally disintegrating tablets having the same effect, adhesiveness and disintegration varies depending on the drug.
Conclusions : Medication difficulties appear to occur regardless of medication independence, regular meal texture, results of swallowing screening tests or the dosage form. Clinical observation and cooperation by medical staff responsible for medication management are therefore necessary.
