Table 2.

Pill-swallowing aids for people with pill-swallowing difficulties^a

Device	Function	Comments	Illustration
Pill- swallowing cups	• Pill is placed inside the mouthpiece so that it enters the mouth and is swallowed with the flow of the liquid from the cup21	• No evidence available on effectiveness and safety in people with or without pill-swallowing difficulties • Risk of aspiration in patients with dysphagia should be considered as it encourages head back position, use of thin liquids, and whole pills, any of which may not be safe for patients with dysphagia
Pill- swallowing straws	• Pill is dropped onto the straw shelf and the straw is placed into the desired liquid. The consumer then drinks the liquid from the straw. The flow of the liquid suspends the pill and carries it into the mouth as the pill and liquid are swallowed together22	• No evidence available on effectiveness and safety in patients with or without pill-swallowing difficulties • The manufacturers state that the straws reduce or eliminate gagging and choking but no evidence is available.22 Pill swallowing through the straw encourages the head neutral (central) or chin-down position, which are favored by people with pill-swallowing difficulties • Risk of aspiration in patients with dysphagia should be considered as it requires the use of thin liquids and whole pills, both of which may not be safe for patients with dysphagia23–25
Pill coating devices	• Pill is pushed through the applicator, which covers it with the flavored, slippery coating. This makes tablet easier to swallow and masks the taste	• Improved pill swallowing in 40/41 of healthy adults with pill-swallowing difficulties with 54% reporting that swallowing pills become “much easier”27 • Improved flavor reported by 100% of participants27 • Generally regarded as safe in terms of interacting with drugs27 • No evidence is available in patients with dysphagia
Lubricant gels	• Pills are placed on a tablespoon and covered with a spoonful of gel before administering to patients • Lubricates and hides the solid dosage forms within the gel, and therefore makes them easier to swallow and slip down the oropharyngeal tract. • The flavored formulation can mask unpleasant tastes	• No evidence currently available for effectiveness and safety in people with or without pill-swallowing difficulties • No physicochemical interactions with medications tested26 • No evidence in patients with dysphagia; consider whether the thickness of the gel is appropriate to prevent aspiration
Lubricant sprays	• Several puffs sprayed to the back of the mouth and throat before taking pills • Lubricates the oral cavity and masks unpleasant tastes	• Improved pill swallowing among adolescents with self-reported pill-swallowing difficulties28 • No evidence available in patients with dysphagia

Note:

^aNot recommendable for patients with dysphagia without thorough clinical evaluation.