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Should dysphagia patients have crushed medications?

2 February 2023

Last week on LinkedIn we read about a podcast created by Theresa Richards, an American Speech Pathologist and specialist in Swallowing and Swallowing Disorders. It discusses medication and the issues for Speech Pathologists (Therapists).

It’s well-known Speech Therapists receive a continual flow of referrals when a patient can’t swallow their pills. Typically, the “work around” is to crush or split pills and capsules. However, there are several issues with this.

To name a few… crushing or splitting will affect the bioavailability (effectiveness) of the medication. Time release medication can’t be crushed. It changes the medication into an un-licensed product. If added to food, the food can affect the dissolution of medication, especially yoghurts, jams and ice creams due to their sugar content. Placing medication in foods then creates lots of legal issues.

Theresa doesn’t suggest Speech Therapists turn into the “Medication Police” or learn about the pharmaceutical properties of medication and spend hours studying the NEWT Guidelines (

It’s more about combining the specialist knowledge of all members of the care team e.g. helping pharmacists understand the impact a patient’s dysphagia diagnosis has on their ability to swallow certain pills; pharmacists helping clinicians to understand the implications crushing and adding medication to food has on its effectiveness.

As a result, alternatives can be found that will ultimately help the patient. It may be switching slow-release medication for a quicker one taken more frequently, use our Pill-Eze: or, as a last resort, switch to a liquid version.

Of course, before all this happens it would be useful to establish what swallowing issue a patient has. A team unaffiliated to Theresa created the Pill 5 questionnaire. A series of 5 questions which will determine the level of difficulty a patient has swallowing pills. You can download a copy here: Slõ Pill 5.

Please do try and listen to the podcast, it really is worth a listen and contains lots of valuable information. If you use LinkedIn, just search for “Should dysphagia patients have crushed medications” or Theresa.

If you don’t use it, you can go straight to Theresa’s podcast by clicking the link below. You will also find lots of other interesting podcasts and useful tools on her site:

* NEWT Guidelines. A guide created here in the UK to administration of medication to patients with swallowing problems. Such administration is usually outside the product license.

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