A qualitative study exploring the views of healthcare professionals regarding patients who have difficulty swallowing medicines

BACKGROUND: In the hospital setting healthcare professionals (HCPs) are involved in medicines management for patients with difficulty swallowing solid oral dose forms (SODF), which can present unique challenges. AIM: To investigate HCPs' views and identify resulting appropriate behaviour change strategies for HCPs to optimise the care of patients with difficulty swallowing SODF in an acute hospital setting. METHOD: Between 3rd June and 12th July 2024 qualitative, semi-structured, in-person/online interviews with HCPs working in an Irish hospital, were conducted. Initial open coding of transcripts generated non-hierarchical codes with subsequent categorisation into themes. The Theoretical Domains Framework (TDF) provided predetermined codes and facilitated a directed content analysis. Dominant TDF domains were identified and mapped to the Capability Opportunity Motivation-Behaviour (COM-B) model and Behavioural Change Wheel. RESULTS: A total of 13 HCPs participated in the study (n = 12 female; n = 4 doctors, n = 3 nurses, and n = 2 dietitians, speech & language therapists and pharmacists respectively), with average interview length of 22 min (range 12-32 min). Eight TDF domains were found to be dominant: Memory Attention & Decision Processes; Environment, Context and Resources; Knowledge; Social/Professional Role and Identity; Goals; Beliefs about Consequences; Behavioural Regulation and Intentions. HCPs identified swallow assessments for medicines, decision support tools and multidisciplinary team (MDT) input as important enablers of safe patient care. CONCLUSION: HCPs require the provision of education, and training, suitable infrastructure and access to evidence-based information to appropriately care for patients with difficulty swallowing SODF in the acute hospital setting. Future work should seek to address these issues through tailored interventions.