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Updated Evidence on the Use of Solid Oral Dosage Forms in Adults with Neurological Disorders and Swallowing Difficulties: A Scoping Review

Speaker(s)

Ferreira-Neto C1, Andrade RA1, Tonin F2, Wiens A3
1State University of Ponta Grossa, Ponta Grossa, Brazil, 2Federal University of Paraná, Curitiba, PR, Brazil, 3Federal University of Paraná, Curitiba, Brazil

OBJECTIVES: To synthetize the evidence on the available interventions aimed at the effective and safe use of solid oral dosage forms (SODFs) in adult patients with neurological disorders and swallowing difficulties and to identify potential gaps in the literature.

METHODS: This scoping review was performed following Joanna Briggs Institute recommendations and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Systematic searches were conducted in PubMed, Scopus, SciELO (March-2021). Peer-reviewed observational studies assessing the effect of SODFs in patients with any type of neurological disorder and swallowing difficulties in healthcare settings were included. According to the Medicine Optimization Recommendations of the National Institute for Health and Care Excellence, eligible interventions were classified as targeting patients, healthcare organizations, or healthcare professionals.

RESULTS: Overall, n=11 studies were included (six analytical studies, three case reports and two mixed-methods intervention studies). Patients’ age ranged from 57 to 91 years; most of them were women with Parkinson's disease (n=6 studies; 54.5%) or dementia (n=3 studies; 27.3%). All studies evaluated tablets; n=6 provided data on hard gelatin capsules and n=4 assessed dispersible or disintegrating dosage forms. A total of 26 interventions were reported being the most prevalent medication review (9/26; 35%), followed by medicines-related models of organizational and cross-sector working (4/26; 15%). In most studies, interventions were performed by physicians (n=8; 72.7%) and targeted patients during hospitalization (n=7; 63.6%). Interventions’ duration ranged from 55 minutes to 6 months. At least 20 different outcomes were evaluated. Patient's swallowing of SODFs preferences was analyzed only by n=5 (45.5%) studies.

CONCLUSIONS: The implementation of specific protocols for using SODFs in patients with swallowing difficulties and neurological disorders is not a standard practice. Further studies on this field are needed to support the use of effective and safe oral therapy for these patients.

Code

CO9

Topic

Clinical Outcomes

Topic Subcategory

Clinical Outcomes Assessment, Comparative Effectiveness or Efficacy

Disease

Geriatrics, Neurological Disorders