Are you a healthcare professional, dealing with the crushing
of tablets on a daily basis?
Are you curious to find out how you will be able to
decrease the amount of crushes and decrease costs
connected to this?
In that case you would want to read this white paper.
Table of content:
- Problems crushing medication
- How to decrease crushing
- Cost- benefit analysis
You are a healthcare professional, working with patients or
clients on a daily basis and giving it your all to make life just
a bit easier or better for them. One essential part of patient
care is the use and misuse of medication.
On a daily basis healthcare professionals are busy with pills
and capsules, powders and fluids. Is it the right medication,
is it the right dosage, is the patient allergic to anything, can
the pills be crushed, can the patient take whole tablets and
In 2017 in just a small country as the Netherlands (17 million
inhabitants) the pharmaceutical costs were € 4.390 million
(source: Data en Feiten stichting Farmaceutische Kengetallen), so that means millions of pills worldwide.
Administering medication in a correct way is a everyday
struggle and concern for many healthcare professionals,
and crushing tablets because of various reasons is daily
practice. In some cases this is allowed, but there are many
medicines that are cannot be crushed, and crushing them
can lead to big problems. Second problem is that if the medication is allowed to be crushed, the crushing is time consuming and often leads to health problems for the nurse
doing the crushing on a daily basis. It is known that manual
crushing on a regular base often leads to wrist problems.
Often people haven’t even thought about the micro dust
that comes off all those crushed pills, can you imagine what
a nurse breaths in and gets on her skin?
And not even that; what does it cost to crush medication?
Depending on your devices on the wards, it can take from
30 seconds up to 3 minutes to crush medication. This in a
world of shortage of educated nurses is not at all ideal. Plus;
as you crush medication, the liability is no longer with the
manufacturer of the pill, as he stated that altering the medication is not the intended use [1,5].
So if there would be a device that could help you with decreasing the amount of crushes on a daily basis, it would
probably be of your interest. If you want to find out how
this could work for you, put your number in the cost benefit
Problems with crushing tablets:
All over the world an enormous amount of medicines are
crushed every day. Reasons to crush are variable, but mostly
due to psychological or physical problems. MIP (medication
intake problems) are often psychological, as peoples body
and brain simply refuse to swallow hard pills or tablets. If
not psychological, than the physical reason is often a result
from an underlying disease or illness. Dysphagia is a swallowing issue, which is often seen in elderly patients, in people
with Parkinson’s disease, Multiple Sclerosis or after a Stroke.
These are the people that would need their pills crushed.
The decision to crush medication should always be taken
carefully, and alternatives should be tried when safe for the
patient. Possible results of crushing could be:
- The nurse is exposed to micro dust of the
medication. Inhalation via lungs and skin are a
- Wrist problems are a common complaint with
nurses that do manual crushing on a daily basis.
- Altering medication is off-label use, which
means the manufacturer is no longer liable.
- Altering of a dosage may reduce stability,
efficacy and palatability, and increase toxicity.
- Dose- dumping can occur when slow release
tablets are crushed, which basically means a
massive overdose (in 30 minutes you
administer the dosage made for 24 hours).
Even deaths have been reported.
- When enteric coated tablets are crushed, this
could lead to destruction of the drug by the
stomach acid, or local adverse effects in the
- Consider the side effects; if the drug is
irritant, crushing may increase erosion in the
mouth or esophagus .
In this white paper we don’t go in depth when it comes to
using food as an intake vehicle for medication, but there are
many scientific studies stating that food is most often not
the best choice for the intake of oral medication, due to the
many interactions known and unknown with drugs[2,3,4].
So, with all that in mind, it is safe to say that you would
want to avoid crushing of tablets as much as possible. We
are aware of the fact that there will always be patients that
cannot swallow whole tablets, due to the physical conditions, but from experience we know that there is always a
group of patients that are able to swallow comp...
Published by Gloup Me