1. Royal College of Speech and Language Therapists (RCSLT). Dysphagia. In: Communicating quality 3. 3rd ed. London: RCSLT. 2006: 319-321.
2. Scottish Intercollegiate Guidelines Network (SIGN). Management of patients with stroke: identification and management of dysphagia. June 2010. No. 119.
3. Manikantan K, Khode S, Sayed SI, Roe J, Nutting CM, Rhys-Evans P, Harrington KJ, Kazi R. Dysphagia in head and neck cancer. Cancer Treat Rev. 2009; 35(8): 724-32
4. Lindgren S, Janzon L. Prevalence of swallowing complaints and clinical findings among 50-79-year-old men and women in an urban population. Dysphagia. 1991; 6: 187-92.
5. Steele C, Caslpo R, Greenwood C, Ens I, Robertson C, Seidman-Carlson R. Mealtime difficulties in a home for the aged: not just dysphagia. Dysphagia. 1997; 12: 45-50.
6. Carnaby-Mann G, Crary M. Pill swallowing by adults with dysphagia. Arch Otolaryngol Head Neck Surg. 2005; 313: 970-5.
7. Society for the Advancement of Education, Swallowing difficulties cause for concern. USA Today; October 2004: p.14.
8. Kelly J, de Cruz G and Wright D. A qualitative study of the problems surrounding medicine administration to patients with dysphagia: Dysphagia. 2009; 24: 49-56.
9. Wright DJ (ed). Prescribing Medicines for Patients with Dysphagia. Grosvenor House Publishing; 2011.
10. Ertekin C, Aydogdu I. Neurophysiology of swallowing. Clin Neurophysiol. 2003; 114(12): 2226-2244.
11. Broadley S, Cheek A, Salonikis S, et al. Predicting prolonged dysphagia in acute stroke: The Royal Adelaide Prognostic Index for Dysphagic Stroke (RAPIDS). Dysphagia. 2005; 20(4): 303-310.
12. American Speech-Language-Hearing Association. Communication Facts: Special Populations: Dysphagia - 2008 Edition. (Accessed May 2012).
13. Cichero J and Murdoch B. Dysphagia – Foundation, Theory and Practice: London, Wiley 2006.
14. Bloem B, Lagaay A, van Beek W, Haan J, Roos R, Wintzen A. Prevalence of subjective dysphagia in community residents aged over 87. BMJ. 1990; 300: 721-2.
15. Hospital Episode Statistics, Admitted Patient Care - England, 2014-15. Health & Social Care Information Centre. Accessed April 2016.
16. Strachan I and Greener M. Medication-related swallowing difficulties may be more common than we realise. Pharm Pract. 2005; 15: 411-14.
17. McGavok H. How drugs work. Basic pharmacology for healthcare professionals, 2nd ed. Oxford: Radcliffe Publishing; 2005.
18. Preston M, Morris H. Dysphagia, the impact on dispensing doctors. Dispensing Doctor J. 2005; 21: 11-5.
19. Andersen O, Zweidorff O, Hjelde T, Rodland E. Problems when swallowing tablets. A questionnaire study from general practice. Tidsskr Nor Laegeforen. 1995; 115: 947-9.
20. Department of Health. Valuing people: A new strategy for learning disability for the 21st century—a white paper. London: Department of Health, 2001.
21. Emerson E, Hatton C. People with Learning Disabilities in England. Centre for Disability Research, Lancaster.
22. Mencap. Death by indifference: 74 deaths and counting. A progress report 5 years on. London: Mencap, 2012.
23. Hollins S, Tuffrey-Wijne I. Meeting the needs of patients with learning disabilities. BMJ 2013; 346: f3421.
24. Leslie P, Crawford H, Wilkinson H. People with a learning disability and dysphagia: A cinderella population? Dysphagia 2009; 24 (1): 103-104.
25. Chadwick D, Joliffe J. A descriptive investigation of dysphagia in adults with intellectual disabilities. J Intellect Disabil Res 2009; 53 (1): 29-43.
26. National Patient Safety Agency. Learning disabilities dysphagia protocol for general practitioners. National Patient Safety Agency, 2007.
27. World Gastroenterology Organisation. Dysphagia Global Guidelines and Cascades. World Gastroenterology Organisation, Update September 2014. (Accessed April 2016).
28. Harding C, Wright J. Dysphagia: The challenge of managing eating and drinking difficulties in children and adults who have learning disabilities. Tizard Learning Disability Review 2010; 15 (1): 4-13.
29. Royal College of Speech and Language Therapists. Adults with learning disabilities Position Paper. May 2010.
30. Wright D, Beavon N, Branford D et al (2013) Guideline for the Identification and Management of Swallowing Difficulties in Adults with Learning Disability. (Accessed: June 2014)
31. Lewis T. Using the NO TEARS tool for medication review. BMJ 2004; 329: 434.
32. National Patient Safety Agency. Ensuring safer practice for adults with learning disabilities who have dysphagia 2009. (Accessed May 2012)
33. White R, Bradnum V (eds). Handbook of Drug Administration via Enteral Feeding Tubes. London: BPNG; 2006.
34. Elia M. trends in artificial nutrition support in the UK during 1996-2000. Redditch: British Association of Enteral and Parenteral Nutrition; 2001.
35. Johns Hopkins Hospital Division of Gastroenterology & Hepatology. Swallowing Disorders: Introduction. (Accessed June 2012)
36. BMJ BestPractice. Assessment of dysphagia. (Accessed May 2012).
37. White GN, O’Rourke F, Ong BS, Cordato DJ, Chan DKY. Dysphagia: causes, assessment, treatment, and management. Geriatrics. 2005; 63: 15-20.
38. Westergren A. Detection of eating difficulties after stroke: a systematic review. Int Nurs Rev. 2006; 53(2): 143-149.
39. Ingelfinger FJ, Kramer P, Soutter L, et al. Panel discussion on diseases of the esophagus. Am J Gastroenterol. 1959; 31: 117-131.
40. Logemann J. Evaluation and Treatment of Swallowing Disorders, 2nd Edition: Texas: Pro-Ed.;1998.
41. Lim SH, Lieu PK, Phua SY, et al. Accuracy of bedside clinical methods compared with fiberoptic endoscopic examination of swallowing (FEES) in determining the risk of aspiration in acute stroke patients. Dysphagia. 2001; 16(1): 1-6.
42. Langmore SE. Endoscopic Evaluation and Treatment of Swallowing Disorders. New York, Thieme; 2001.
43. Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest. 2003; 124(1): 328-336.
44. Nakajima M, Kimura K, Inatomi Y, et al. Intermittent oroesophageal tube feeding in acute stroke patients – a pilot study. Acta Neurol Scand. 2006; 113(1): 36-39.
45. NHS Choices. Dysphagia – Treatment. (Accessed June 2012)
46. Wright D., Chapman N., Foundling-Miah M., Greenwall R, Griffith R., Guyon A. & Merriman H. Consensus Guidelines on the Medication Management of Adults with Swallowing Difficulties. Medenium Group Publishing, Berkhamstead; 2006.
47. NEWT Guidelines for administration of medication to patients with enteral feeding tubes or swallowing difficulties. (Accessed June 2012).
48. Fair R, Proctor B. Administration of medicines through enteral feeding tubes, 2nd ed. Belfast: The Royal Hospital; 2005.
49. Simpson C. Crushed medications: an emerging guideline. Aust Nurs J. 2005: 13:1-3.
50. National Institute for Health and Clinical Excellence. Clinical guideline 32: Nutrition support in adults. London: NICE, February 2006.
51. Department of Health. National service framework for older people. London: DH, 2001.
52. Teng J et al. Lack of medication dose uniformity in commonly split tablets. J Am Pharm Assoc. 2002; 42(2): 195-199.
53. Beckwith MC, Feddema SS, Barton RG, Grave C. A guide to drug therapy in patients with enteral feeding tubes: dosage for selection and administration methods. Hosp Pharmacy. 2004; 39: 225-37.
54. Holland G, Jayasekeran V, Pendleton N, Horan M, Jones M, Hamdy S. Prevalence and symptom profiling of oropharyngeal dysphagia in a community dwelling of an elderly population: a self- reporting questionnaire survey. Dis Esophagus 2011; 24: 476–80.
55. British Association for Parenteral and Enteral Nutrition (BAPEN). Drug administration via enteral feeding tubes: a guide for general practitioners and community pharmacists.
56. Powers JE, Cascella PJ. Comparison of methods used to prepare tablets for nasogastric tube administration. J Pharm Technol. 1990; 6: 60-62.
57. Lord L. Restoring and maintaining patency of enteral feeding tubes. Nutr Clin Pract. 2003; 18: 422-426.
58. GMC. Good practice in prescribing and managing medicines and devices. January 2013 (Updated December 2014). (Accessed May 2016).
59. MHRA. Off-label or unlicensed use of medicines: prescribers’ responsibilities. MHRA. Drug Safety Update. Volume 2, Issue 9. April 2009.
60. National Pharmacy Association. Use of unlicensed medicines: information factsheet. September 2010.
61. MHRA. The supply of unlicensed medicinal products (“specials”). MHRA Guidance Note 14. MHRA 2014. (Accessed May 2016).
62. Pharmacy Professional. Dealing with Specials. Good practice guidance on the procurement and supply of pharmaceutical specials. Royal Pharmaceutical Society, June 2010.
63. Prescribing Specials, Five guiding principles for prescribers, National Prescribing Centre. National Institute for Health & Clinical Excellence. 2011.
64. Drugs specials cost NHS £160 m. BBC News website. (Accessed June 2012).
65. HSCIC. Prescriptions Dispensed in the Community, Statistics for England. (Accessed May 2016).
66. Mistry B, Samuel S, Bowden S, McArtney R, Roberts D. Simplifying oral drug therapy for patients with swallowing difficulties. Pharm J. 1995; 254: 808-809.
67. Belknap D, Seifert C, Petermann M. Administration of medications through enteral feeding catheters. Am Journal of Crit Care. 1997; 6(5): 225-237.
68. Tissot E, Cornette C, Demoly P, Jacquet M, Barale F, Capellier G. Medication errors at the administration stage in an intensive care unit. Intensive Care Med. 1999; 25(4): 353-359.
69. Paradiso L, Roughead E, Gilbert A, Cosh D, Nationa R, Barnes L, Cheek J, Ballentyne A. Crushing or altering medications: what’s happening in residential aged-care facilities? Australasian Journal of Aging. 2002; 21(3): 123-127.
70. Wright D. Medication administration in nursing homes. Nursing Standard. 2002; 16(42): 33-38.
71. Kirkevold O, Engedal K. Concealment of drugs in food and beverages in nursing homes: cross sectional study. BMJ. 2005; 330(7481): 20-22.
72. Barnes L, Cheek J, Nation R, Gilbert A, Paradiso L, Ballentyne A. Making sure the residents get their tablets: medication administration in care homes for older people. Jnl Adv Nursing. 2006; 56(2): 190-199.
73. Williams N. Medication administration through enteral feeding tubes. American Journal of Health-System Pharmacy. 2009; 65(24): 2347-2357.
74. Royal College of Speech and Language Therapists (RCSLT). RCSLT Resource Manual For Commissioning And Planning Services For SLCN. Dysphagia. RCSLT 2009 (literature synthesis updated 2014). (Accessed April 2016).
75. UKMi. Medicines Q&A 294.1a: Therapeutic options for patients unable to take solid oral dosage forms. December 2009 (partial revision January 2010). Available online at:
76. Pharmaceutical Issues when Crushing, Opening or Splitting Oral Dosage Forms. Royal Pharmaceutical Society. June 2011.
77. Schier JG, et al. Fatality from administration of labetalol and crushed extended-release nifedipine. Annals of Pharmacotherapy. 2003; 37:1420-1423.
78. Wright W. Tablet crushing is a widespread practice but it is not safe and may not be legal. Pharm J. 2002; 269: 132.
79. Murhammer J, et al. Medications that should not be crushed. 2004.
80. Gowan J. Crushing tablets – issues to consider. 2010.
81. NEEMMC Guidelines for tablet crushing and administration via enteral feeding tubes. Colchester Hospital University NHS Foundation Trust, NHS North East Essex. April 2015.
82. Cleary JD, et al. Administration of crushed extended-release pentoxifylline tablets: bioavailability and adverse effects. American Journal of Health-System Pharmacy. 1999; 56: 1529-1534.
83. Mandal TK. Effect of tablet integrity on the dissolution rate of sustained-release preparations. Journal of Clinical Pharmacy and Therapeutics. 1996; 21: 155-157.
84. Broadhurst EC, et al. Dose uniformity of samples prepared from dispersible aspirin tablets for paediatric use. EJHP Science. 2008; 14(2): 27-31.
85. Tomlin S, Cockerill H, Costello I, Griffith R, Hicks R, Sutcliffe A, Tuleu C, Wong ICK, Wright D. Making medicines safer for children - guidance for the use of unlicensed medicines in paediatric patients. Berkhamsted: MGP Ltd; 2009.
86. Managing Drug Supply 2nd edition, Kumarian Press; 1997.
87. Marshall IW, Daly MJ. Risk Management in hospital pharmacy. Pharma Manage. 1996; 12: 44-47.
88. Lowey A, Jackson M. Handbook of Extemporaneous Preparation - A guide to pharmaceutical compounding. London; Pharmaceutical Press; 2010.
89. Anon. Baby dies after peppermint water prescription for colic. Pharm J. 1998; 260: 768.
90. Crawford SY, Dombrowski SR. Extemporaneous compounding activities and the associated needs of pharmacists. Am J Hosp Pharm. 1991; 48: 1205-1210.
91. Pappas A, McPherson R, Stewart K. Extemporaneous dispensing: Whatever happened to it? A survey of Australian general practitioners. J Pharma Res. 2002; 32: 310-314.
92. Chowdury T, Taylor KMG, Harding G. Teaching of extemporaneous preparation in UK Schools of Pharmacy. Pharm Educ. 2003; 3: 229-236.
93. Fenton-May V, ed. Guide to the Preparation of Non-Sterile Extemporaneous Products in National Health Service (NHS) Hospitals. London: NHS Quality Assurance Committee; 2003.
94. Professional Standards and Guidance for the Sale and Supply of Medicines. The Royal Pharmaceutical Society of Great Britain. (
95. Counterfeit Drugs Kill. World Health Organization (updated May 2008).
96. The Patients Association. Survey of medicines related care of residents with dysphagia in care homes. October 2015. (Accessed April 2016).
97. Royal Pharmaceutical Society. Professional Guidance for the Procurement and Supply of Specials. December 2015. (Accessed April 2016).
98. Association of Pharmaceutical Specials Manufacturers. How specials can deliver value to the NHS without compromising patient safety. Specials White Paper. June 2015.