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

Dr Asia Rashed, King’s College London

Whilst adults are usually given tablets or capsules, children are most often given oral liquid medicines. However there is evidence to show that children are capable of swallowing tablets and capsules, particularly if they are taught how to do it from a young age. Liquid medicines are not without their problems: short expiry, unpleasant taste, measuring the right volume of the medicine, inconvenient to store and carry, and cost (e.g. warfarin liquid bottle cost £100, 28 tablets below £2). Using a tablet or capsule can reduce these disadvantages. 

We want to test the possibility of establishing Pill School within the NHS to provide swallowing training sessions to children. Also, we want to find out how many children can be swapped from liquid medicines to tablets/capsules, and if the child and their parent/carer involved in the project like the change.  

This project will be conducted in three children’s hospitals in England. To complete the project we will: 

  1. Collect data on the current use of liquid medicines in the three hospitals for all children, to identify the number that could be given in tablets/capsules forms instead. 
  2. Introduce swallowing training session (called Pill School) to enable children (aged 3-18 years) to make the switch from liquids to tablets/capsules safely. 150 children will be entered into the study while they are in hospital – half will go to Pill School early and the comparison group will go to Pill School later on.
  3. Ask parents/carers and their children (if old enough and engaged), after they go home, what they think about Pill School using a questionnaire. 

Throughout the project we will work with Parent and Young Persons’ Advisory Groups to guide us and help tell others what we find. We believe that the impact of this project will have immediate benefits to children and their parents/carers and will have a national impact on the NHS within a short time-frame. 

What we find will be made known nationally and internationally to all interested groups including the public, healthcare professionals and academics. We will use the findings of this project to conduct further research to see if Pill School can be run successfully and sustained across the NHS and we will see if it saves money. 

Final report available to view here.