'Good ways to pop a pill'

“Just a spoonful of water helps the medicine go down: Scientists discover the best way to swallow tablets,” explains the Mail Online today.

In fact, scientists haven’t necessarily discovered the “best” ways to take your medicine, they have simply tested two options and found that they work well – and neither involves just a spoonful of water.

The best ways to swallow medicine – according to the new research cited by the Mail – are a “pop-bottle” method for tablets and a “lean-forward” technique for capsules.

German researchers asked adults with and without swallowing difficulties to swallow 16 tablets and capsules of different shapes and sizes using 20ml of water, with their eyes shut. The most difficult tablet and capsule were then chosen to test whether the two alternative techniques were better.

The pop-bottle method was rated easier to use for swallowing tablets by 60% of participants regardless of whether they had an initial swallowing difficulty. The lean-forward technique for capsules improved swallowing in 89% of people. Overall, 86% of the people said they would use the techniques in the future.

Both techniques appear to have been successful for the majority of people, and may be worth a go if you have mild difficulty swallowing pills. If you have a more general swallowing problem, speak to your GP or pharmacist about different techniques for taking medicine or alternative formulations, such as medicine in liquid form.

Where did the story come from?

The study was carried out by researchers from the University of Heidelberg and was funded by the Fette Compacting GmbH, the German Research Foundation, and the German Federal Ministry of Education and Research.

The study was published in the peer-reviewed medical journal Annals of Family Medicine.

The Mail Online helpfully provided diagrams to explain the two techniques, but it did not accurately reflect the experiment. Slurping from a tablespoon of water was not tried in this research, although in each of the initial pill-swallowing experiments 20ml (about a tablespoon) of water was used, but this was not found to be the most effective method.

What kind of research was this?

This cross-sectional study aimed to determine the optimal technique for swallowing tablets and capsules. Difficulty in swallowing pills can lead to non-compliance with medication or the need to have it administered in a different form, so the researchers wanted to find out the easiest way that the majority of people would find to take them.

What did the research involve?

To investigate different swallowing techniques, 151 adults from the general population in Germany were enrolled in the study. They were asked to swallow 16 dummy pills of different sizes and shapes with their eyes closed using 20ml of water, and rate the ease of swallowing. The largest tablet and capsule that had caused the most difficulty were then chosen to be swallowed again to test two particular techniques – the “pop-bottle method” for the tablet and the “lean-forward technique” for the capsule – to see if they made it easier to swallow them.

Pop-bottle method

The pop-bottle method involves placing the tablet on the tongue, tightly closing the lips around the top of a plastic bottle filled with water, and swallowing in a “swift suction movement” to overcome the “volitional phase of swallowing” (the conscious act of swallowing). No air should enter the bottle as you swallow, and the bottle will squeeze in on itself as you drink the water. This method was devised for tablets because they are usually of high density.

Lean-forward technique

The lean-forward technique requires swallowing the capsules whilst in an upright position, with the head bent forward. This version was deemed appropriate for capsules, as they are usually very light.

The researchers then compared the rating of these two techniques, with the initial rating of how easy the tablet and capsule had been to swallow.

What were the basic results?

Compared to swallowing with 20ml of water, the pop-bottle method improved the ease of swallowing the tablet for 60% of people. This included people who had not found it difficult in the first place.

The capsule swallowing was tested only 35 times, and the lean-forward technique was rated better by 89% of participants. This compared to the capsules lodging in the back of the throat on 10 out of 33 occasions without the technique.

Overall, 86% of participants said they would now use these techniques for swallowing pills.

How did the researchers interpret the results?

The researchers conclude that, “this study showed for the first time that two targeted techniques to facilitate tablet and capsule intake were remarkably effective and easy to adopt in the general population, including patients with swallowing difficulties, and should therefore be generally recommended”.

Conclusion

This study has demonstrated that two specific techniques for swallowing tablets and capsules were beneficial in the majority of people studied. This included people who have trouble swallowing the pills as well, as the controls who didn’t normally have swallowing problems.

While the results of this study seem impressive for these techniques, it should be noted that they were compared to swallowing the pills with just 20ml of water, which is equivalent to a sip or a small mouthful, if you have a small mouth.

The participants also had their eyes closed during this phase of the experiment, which may have been disorientating and made swallowing a pill more unnatural. Also, by the time the participants tested the new techniques, they would have just swallowed 16 tablets, so it could be argued that they would have got more used to doing so by then.

Nevertheless, it is encouraging to have two new techniques to try if you do have difficulty swallowing pills. However, bear in mind that the authors suggest the pop-bottle technique carries some potential risk of getting the pill lodged in your airway (aspiration).

If you have a condition where you have problems with swallowing in general (dysphagia), it may be better to try new techniques under medical supervision.