Dysphagia & Medication Adherence

What is Dysphagia?

Dysphagia—difficulty swallowing—affects millions of Americans, particularly older adults who may be managing chronic conditions like hypertension. This common but often overlooked condition can significantly impact medication adherence and, consequently, health outcomes.

For individuals with hypertension who require daily medication, dysphagia presents a serious challenge to consistent treatment. Arbli™ (losartan potassium) oral suspension offers a solution as the first and only FDA-approved liquid losartan specifically designed for patients who have difficulty swallowing tablets.

Around 30% of community-dwelling older adults and 59% of aged care residents are affected by dysphagia.1

Pill-specific dysphagia is experienced by around 14% of community-dwelling older adults and 10 to 30% of aged care residents.2,3

The Hidden Challenge

Many people who can swallow food and liquids comfortably still struggle specifically with pills and tablets. This condition is known as pill-specific dysphagia.

For these individuals, taking essential medications like losartan in pill form can become a daily struggle, potentially leading to:

  • Medication avoidance
  • Inconsistent dosing
  • Exposure to potential dangers of pill splitting or crushing

How Dysphagia Affects Medication Adherence

Research shows difficulty swallowing pills directly impacts medication adherence, which can lead to serious health consequences:⁴

  • Physical discomfort when attempting to swallow pills
  • Anxiety and fear around medication times
  • Incomplete medication ingestion or tablet regurgitation
  • Improper modification of medications (crushing when not recommended)

The health impact for patients suffering from high blood pressure can be inconsistent blood pressure control, increased risk of stroke and heart attack, higher rates of hospitalization, and decreased quality of life.

Actor portrayal, not actual patient

Risk Factors

While dysphagia can affect people of all ages, certain populations are at higher risk.

What are the risk factors for dysphagia?

  • Advanced age (prevalence increases significantly after 50)

  • Neurological conditions (stroke, Parkinson’s disease, multiple sclerosis)
  • Head and neck cancers or treatments
  • Dementia and cognitive impairments
  • GERD (gastroesophageal reflux disease)
  • Anxiety around pill-taking

When to suspect dysphagia in patients:

  • Complaints about pills “getting stuck”
  • Coughing or choking when taking medications
  • Requesting to crush medications
  • Unexplained medication non-adherence
  • Avoiding taking medications when others are not present to help

References

  1. Thanh-Nhan D, Wen-Chao H, Liang-Hui W, Fei-Chun C, Nguyen TN, Li-Wei C. Prevalence and methods for assessment of oropharyngeal dysphagia in older adults: a systematic review and meta analysis. J Clin Med. 2022;11(9):2605. https://doi.org/10.3390/ jcm11092605
  2. Mc Gillicuddy A, Crean AM, Sahm LJ. Older adults with difficulty swallowing oral medicines: a systematic review of the literature. Eur J Clin Pharmacol. 2016;72:141–51. https://doi.org/10.1007/s00228-015-1979-8
  3. SefidaniForough A, Lau ETL, Steadman KJ, Kyle GJ, Cichero JAY, Serrano Santos JM, Nissen LM. Factors that affect healthcare workers’ practices of medication administration to aged care residents with swallowing difficulties: an Australia-wide survey study. Australas J Ageing. 2021;40(1):e79–86 https://doi.org/10.1111/ajag.12856
  4. Sefidani Forough A, Lau ET, Steadman KJ, Cichero JA, Kyle GJ, Serrano Santos JM, Nissen LM. A spoonful of sugar helps the medicine go down? A review of strategies for ma king pills easier to swallow. Patient Prefer Adherence. 2018;1337–46. https://doi.org/10.2147/ppa.S164406