Tablet crushing and medicines manipulation

When a patient has difficulty swallowing a solid medicine, crushing tablets, opening capsules, dissolving/dispersing/ suspending solid medicines not licensed or designed for use in this way, appears to be a widespread practice. This is in spite of the inherent dangers of undertaking such unlicensed medicine manipulation.

In a survey of nursing homes [10], the problem of medication manipulation was widespread:

• Crushing or opening of medication took place in more than 80 per cent of nursing homes on at least a weekly basis
• 61% crushed or opened medication before administration to make it easier to take
• 57% administered medication in food
• 58% of nurses believed that the prescriber might recommend tablet crushing

A community survey [1] found that:

• 60% of patients experienced difficulties swallowing tablets or capsules.
• 68% needed to open a capsule or crush a tablet to be able to swallow their medication.
• 69% had missed taking their solid medication because it proved too hard to swallow. 
• 72% reported that the doctor or nurse had never asked if they had difficulties taking tablets or capsules before writing prescriptions.