September 2002
Research and Teaching

Patients at Risk from Pill Crushing

A new report has revealed that the potentially lethal practice of tablet crushing is widespread in Nursing Homes in the UK.

The Report, published in the Nursing Standard and written by lecturer in Pharmacy Practice David Wright, of the School of Pharmacy, revealed that crushing or opening of medication has taken place in over 84% of nursing homes on at least a weekly basis over the past 12 months and that all the reported cases of crushing were potentially unnecessary.

One in four of Nursing Home residents have swallowing difficulties, which means they find it hard to swallow tablets. Instead of changing the medication, carers are opening capsules and crushing tablets to make it easier for residents to take their drugs.

David said: "Many drugs are specially coated to change the way the drug is absorbed into the body and there is no way of knowing by just looking at the pill. Slow release drugs are meant to deliver the active ingredient over a long period of time - often 24 hours.

"Crushing or opening means that the drug is released a lot quicker than it is designed to be - and this can cause unwanted side effects. This can then be followed by a long period of time when there is no drug in the blood stream, which means patients could be at a higher risk of having a stroke or heart attack."

In the USA, there have been a large number of deaths caused by the crushing of modified release morphine type pain-killer products due to the too-rapid release of the drug. David is recommending more education about the dangers of this practice.

He said: "Crushing may not be at all necessary, appropriate or safe. Lists of medicines, which may not be 'safely' crushed, are regularly produced and updated in the USA and Canada and it is time for the UK to follow suit. Until there are clear guidelines for nurses and carers, countless lives are being unnecessarily put at risk."

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