Enhancing Patient Education on Safe Crushing of Hazardous Oral Medications for Patients With Swallowing Difficulties...

Background Crushing oral hazardous medications (HMs) is often necessary for patients with swallowing difficulties; however, this practice poses significant health risks to caregivers and patients due to exposure to toxic particles and potential alteration of drug properties. Despite existing guidelines, practical implementation in home settings remains limited, especially in the absence of clear, accessible instructions. Methods This interventional study was conducted at a tertiary care hospital in Saudi Arabia. A formulary review identified 26 oral hazardous medications suitable for safe crushing, based on evidence from regulatory sources, leaflet products, and published literature. An educational intervention was developed, including bilingual infographics and standardized medication instructions disseminated via the hospital's electronic medical record (EMR) and mobile application. Fifty participants who were prescribed hazardous oral drugs and required manipulation at home completed a pre- and post-intervention survey assessing knowledge and practices related to preparation, storage, disposal, and spill management. Results Survey findings revealed significant gaps in baseline knowledge: only 17 (34%) participants recognized hazardous medications, 13 (26%) understood associated risks, and 4 (8%) demonstrated appropriate spill management. Following the pharmacist-led intervention, all knowledge domains improved significantly (p < 0.001), with all 50 (100%) participants correctly identifying medication risks, preparation steps, safe disposal practices, and appropriate spill response. A validated list of 26 oral hazardous medications with evidence-based crushing instructions was also compiled to guide safe manipulation at home. Conclusion This study highlights the effectiveness of pharmacist-led counseling and bilingual educational tools in improving caregiver awareness and safety practices when handling hazardous oral medications. Integration of standardized instructions into electronic systems, along with targeted education, can significantly reduce exposure risks in home settings. These findings support broader adoption of structured interventions to ensure safe medication handling and improve patient outcomes.