A pill in the sandwich: Covert medication in food and drink

Treloar, Adrian; Beats, Barbara; Philpot, Michael

doi:10.1177/014107680009300805

Cited by 67 publications

(53 citation statements)

References 5 publications

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“…As identified in this study, the use of enteral tubes as a route for medicine administration can interfere with nutritional intake either because of the time taken for the medicines to be administered through the tube or because the medicines block the tube. Also, although only alluded to, medicines are hidden in food to aid their administration and, in addition to the ethical issue of the covert administration of medicines [19,[50][51][52], the taste of the food itself may be affected with a negative effect on nutritional intake.…”

Section: Nutritionmentioning

confidence: 99%

A Qualitative Study of the Problems Surrounding Medicine Administration to Patients with Dysphagia

Kelly¹,

D’Cruz

Wright

2008

Dysphagia

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Swallowing dysfunction in the elderly is common and affects not only nutrition but also the ingestion of medicines. This qualitative study used a focus group to collect data from ten healthcare professionals who are involved in the care of people with swallowing difficulties. The group discussed their experiences of the problems associated with and solutions to the administration of medicines to patients with dysphagia. The focus group was audiotaped, and the data analysed using Colaizzi’s technique. Six themes were identified, three main ones: (1) the wide spectrum of dysphagia; (2) medicine formulation, which affects how drugs can be administered; (3) problems with data flow, i.e., the correct information being with the right person at the right time and in the right place; and three minor ones which arose from the major themes: (4) the primary function of swallowing is nutrition rather than taking medication; (5) cost of medicines; and (6) therapeutic dilemmas. The study concludes that improvements in interprofessional communication are needed to improve medicine administration to dysphagic patients

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Section: Nutritionmentioning

confidence: 99%

A Qualitative Study of the Problems Surrounding Medicine Administration to Patients with Dysphagia

Kelly¹,

D’Cruz

Wright

2008

Dysphagia

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“…The concealment of medicine in food or beverages is described in non-scientific articles,9 10 and must be a well known practice among carers in nursing homes, but we found only a few scientific papers that report the practice of covert administration. Treloar et al reported that 71% of residential, nursing, and inpatient units in southeast England at least sometimes administered drugs covertly in food and beverages 11. However, the paper did not report how many residents received drugs in this way.…”

Section: Introductionmentioning

confidence: 99%

Concealment of drugs in food and beverages in nursing homes: cross sectional study

Kirkevold

Engedal

2004

BMJ

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Objective To examine the practice of concealing drugs in patients' foodstuff in nursing homes. Design Cross sectional study with data collected by structured interview. Setting All five health regions in Norway. Participants Professional carers of 1362 patients in 160 regular nursing home units and 564 patients in 90 special care units for people with dementia. Main outcome measures Frequency of concealment of drugs; who decided to conceal the drugs; how this practice was documented in the patients' records; and what types of drugs were given this way. Results 11% of the patients in regular nursing home units and 17% of the patients in special care units for people with dementia received drugs mixed in their food or beverages at least once during seven days. In 95% of cases, drugs were routinely mixed in the food or beverages. The practice was documented in patients' records in 40% (96/241) of cases. The covert administration of drugs was more often documented when the physician took the decision to hide the drugs in the patient's foodstuff (57%; 27/47) than when the person who made the decision was unknown or not recorded (23%; 7/30). Patients who got drugs covertly more often received antiepileptics, antipsychotics, and anxiolytics compared with patients who were given their drugs openly. Conclusions The covert administration of drugs is common in Norwegian nursing homes. Routines for such practice are arbitrary, and the practice is poorly documented in the patients' records.

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“…One paper describes how most (71%) residential and nursing-home units in South-East England providing care for people with dementia at least sometimes hide medication in the patients food (Treloar et al, 2000). This paper did not report whether ward characteristics (staffing, ward size, type of ward) or patient characteristics (degree of dementia, ADL function, behavioural function) influenced covert medication.…”

Section: Introductionmentioning

confidence: 99%