Swallowing difficulties cause for concern.

• Position: Medication

Forty percent of American adults have experienced difficulty swallowing pills, even though most have had no problems ingesting food or liquid, according to a nationwide survey conducted by Harris Interactive and sponsored by Schwarz Pharma, Inc., Milwaukee, Wis. Of those, 14% have delayed taking doses of their medication; eight percent have skipped a dose; and four percent have discontinued using their medication.

Moreover, fewer than one-quarter of adults who have trouble ingesting their medication have discussed the situation with a health professional. For 14% of the patients surveyed, their doctor brought up the topic, while 10% initiated the conservation themselves.

"It is alarming that so many Americans are challenged to swallow needed medications, and many are not adhering to the ... treatment recommended by their doctor. Nonadherence and failure of patients to inform their doctor can result in serious health consequences. In addition, patient nonadherence can limit physicians' ability to successfully treat patients, and can increase the cost of health care," warns H. Worth Boyce, Jr., Hugh F. Culverhouse Chair in Esophagology, University of South Florida College of Medicine.

Some key findings include:

* Nearly one in five people who have needed oral medications have hesitated prior to taking prescribed pills because they thought they might have trouble swallowing them. Most attribute it to the size of the pill (84%), followed by shape (29%).

* One in 10 individuals has chosen pills, other than a vitamin, based on...