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.