Training to increase pill-swallowing skills has a number of potential beneficial effects in children with HIV/AIDS, researchers report in the April issue of Pediatrics.
"Participation in pill-swallowing training," lead researcher Dr. Patricia A. Garvie told Reuters Health, "resulted in increased treatment regimen options and access to potentially more potent therapies for these children for whom treatment options previously were limited by few available medications in liquid or powder formulations."
Dr. Garvie of St. Jude Children's Research Hospital, Memphis, Tennessee and colleagues conducted a retrospective review of 23 patients aged 4 to 21 years who were referred for pill-swallowing training. Referrals were made because the children already had difficulties or because of anticipated change in formulary.
The training sessions were conducted by a pediatric psychologist and involved procedures including swallowing pieces of "gummy worm" candy, and then various placebo gel caps of increasing size.
Children aged 2 to 4 years required a median of two sessions to acquire appropriate techniques. Older children required three or more sessions. All but one of the children managed to achieve the necessary skills.
At 6 months after training, the patients showed a significant improvement in medication adherence, CD4+ T cell percentage, and in viral load.
Thus, continued Dr. Garvie, "increased ease of medication administration via pill swallowing related to improved and sustained -- over the short-term -- medication adherence for children with perinatally acquired HIV."
This, she added, led to better health which "was further improved with increased adherence to a new, assumedly more potent, regimen."
Given these encouraging findings, the researchers call for additional study via a prospective, randomized clinical trial of pill-swallowing training to be provided as a standard of care to young children, before "behavioral refusal that is observed in older children becomes an issue."
Pediatrics 2007;119:e893-e899.
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