Maximising access to medicines for children: Setting up “Pill School” in NHS settings to train and support young patients to take tablets and capsules

We are delighted to share the final report of this project grant, led by Asia Rashed at King’s College London and part funded by the Evelina London Children’s Hospital.

What we know already

Children are often given oral liquid medicines. However, evidence confirms that after training children are capable of swallowing tablets and capsules from a young age. Problems associated with use of liquid medicines include: short expiry date, unpleasant taste, measuring correct volume, inconvenient to store and carry, and cost (e.g. a bottle of warfarin liquid (100mL) costs £100; while a box of 28 tablets costs under £2). Using a tablet or capsule can reduce these disadvantages.

What we did

Developed and tested Pill School (PS) to provide swallowing training to children within an NHS hospital. We looked at how many children were able to swap their liquid medicines for pills (tablets/capsules), and if child, parent/carer and healthcare professionals liked the change and continue to use pills. We trained 30 children (and their parents) on paediatric wards (3-18 years) who spoke English, taking oral liquid medications that had a suitable alternative pill form. The participants attended single PS training session with a PS teacher during their hospital stay. Swallowing training was done using sweets of different sizes.

What we found

26 out of 30 children learned how to swallow pills after attending one session of PS, and 24 of them went home taking pills. Children, parents and healthcare professionals liked the PS idea and were supportive of implementing the PS service.

What we need to do next

Since we found that PS training sessions work and that children and their parents and healthcare professional were happy with this initiative, we need to find a way to support the implementation of PS as a routine practice in both hospital and community services.  


The full final report is available to download here.


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