• Pharmacy practice · Apr 2020

    Prevalence of tablet splitting in a Brazilian tertiary care hospital.

    • Vivianne V Melo, Gessyka R Pereira, Amanda Q Soares, Izabel C Silva, Stephania F Taveira, Marcilio Cunha-Filho, and Ricardo N Marreto.
    • MSc. Laboratory of Nanosystems and Drug Delivery Devices (NanoSYS), School of Pharmacy, Federal University of Goiás. Goiânia, GO (Brazil). vivianne90@gmail.com.
    • Pharm Pract (Granada). 2020 Apr 1; 18 (2): 1910.

    BackgroundAlthough a highly common practice in hospital care, tablet splitting can cause dose variation and reduce drug stability, both of which impair drug therapy.ObjectiveTo determine the overall prevalence of tablet splitting in hospital care as evidence supporting the rational prescription of split tablets in hospitals.MethodsData collected from inpatients' prescriptions were analyzed using descriptive statistics and used to calculate the overall prevalence of tablet splitting and the percentage of split tablets that had at least one lower-strength tablet available on the market. The associations between the overall prevalence and gender, age, and hospital unit of patients were also assessed. The results of laboratory tests, performed with a commercial splitter, allowed the calculation of the mass loss, mass variation, and friability of the split tablets.ResultsThe overall prevalence of tablet splitting was 4.5%, and 78.5% of tablets prescribed to be split had at least one lower-strength tablet on the market. The prevalence of tablet splitting was significantly associated with the patient's age and hospital unit. Laboratory tests revealed mean values of mass loss and variation of 8.7% (SD 1.8) and 11.7% (SD 2.3), respectively, both of which were significantly affected by the presence of coating and scoreline. Data from laboratory tests indicated that the quality of 12 of the 14 tablets deviated in at least one parameter examined.ConclusionsThe high percentage of unnecessary tablet splitting suggests that more regular, rational updates of the hospital's list of standard medicines are needed. Also, inappropriate splitting behavior suggests the need to develop tablets with functional scores.Copyright: © Pharmacy Practice and the Authors.

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