The Pharmaceutical Journal
Vol 278 No 7433 p6
6 January 2007

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News summary

Covert medication guidance issued

Guidance on covert medication — the practice of hiding patients' medicines in food or drink — was published by the Mental Welfare Commission for Scotland before Christmas.

The commission says that the legal basis for giving covert medication is unclear but that the practice is widespread in care homes. This was one of the reasons why the guidance was produced.

The guidance stresses that covert medication is not a substitute for explanation and education, and that it should only be considered if the patient lacks the capacity to make a decision. It includes a pathway of issues that should be considered, and evidence recorded, when medicines are given covertly. These include:

• What treatment is being considered and why is it necessary?

• What alternative administration methods were considered?

• How does the patient lack capacity? (record legal documentation)

• What benefits will the patient receive from treatment?

• Who was involved in the decision?

The guidance states that a pharmacist’s advice must be sought on crushing tablets or combining medicines with food or drink.