Gloup

PILL-5 Assessment

A validated questionnaire for difficulty swallowing pills

This screening tool has been developed and validated from an external source. It has been found to be useful for identifying people who have difficulty swallowing tablets.

Read each statement and choose how often you experience it.

You don’t need to give us any details to see your score, and your answers are not recorded. Nothing is stored unless you choose to have your results emailed to you.

1 Pills stick in my throat
2 Pills stick in my chest
3 I have a fear of swallowing pills
4 My problem swallowing pills interferes with my ability to take my medicine
5 I can't take my pills without crushing, coating, or using other forms of assistance

This questionnaire is a screening tool, not a diagnosis. It does not replace advice from a qualified health professional. If you are having difficulty swallowing your medication, speak with your doctor or pharmacist.

Download the printable version (PDF)

Nativ-Zeltzer N, Bayoumi A, Mandin VP, Kaufman M, Seeni I, Kuhn MA and Belafsky PC (2019) Validation of the PILL-5: A 5-Item Patient Reported Outcome Measure for Pill Dysphagia. Front. Surg. 6:43. DOI: 10.3389/fsurg.2019.00043

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