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Tablet Crushing & Medicine Manipulation

Patients with swallowing difficulties often face numerous challenges. One of those challenges could involve taking solid dose medicines e.g., tablets or capsules. It is not uncommon that such patients end up taking solid dose medicines which have been manipulated by either crushing tablets or opening capsules.

This results in many patients taking medicines in a manner that is not aligned with the medicine’s license or intended mode of administration.

A survey involving 17 pharmacies from England and Northern Ireland distributed a questionnaire to patients that pharmacists suspected might experience difficulties swallowing medicines, based upon their clinical judgement and knowledge of the patient[1]. The pharmacists included members of large chains and independents from UK nursing homes.

The questionnaire was designed to determine whether these patients experienced difficulties in swallowing solid medicines. It highlighted the frequent issue of medicine manipulation[1]:

  • 68% crushed or opened medication before administration to make it easier to take
  • 68.4% manipulated medication to help with its swallowing
  • 69% didn’t take tablet or capsule because it was found to be hard to swallow
  • 72% reported that the HCP didn’t ask if they had swallowing difficulties before writing prescriptions




  1. Strachan I and Greener M. Medication-related swallowing difficulties may be more common than we realise. Pharmacy in Practice 2005;15: 411–414