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Tablet Crushing & Medicine Manipulation

When a patient has difficulty in 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 and indicates improper medicines management and medicines administration is common:

  • 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.