European Journal of Clinical Pharmacology

, Volume 62, Issue 12, pp 1065–1073

The frequency of inappropriate tablet splitting in primary care

  • R. Quinzler
  • C. Gasse
  • A. Schneider
  • P. Kaufmann-Kolle
  • J. Szecsenyi
  • W. E. Haefeli
Pharmacoepidemiology and Prescription

DOI: 10.1007/s00228-006-0202-3

Cite this article as:
Quinzler, R., Gasse, C., Schneider, A. et al. Eur J Clin Pharmacol (2006) 62: 1065. doi:10.1007/s00228-006-0202-3

Abstract

Introduction

We assessed the frequency and determinants of tablet splitting in primary care in Germany and evaluated the quality of information on divisibility in the Summary of Product Characteristics (SPCs) and in the Package Leaflet (PL) as legal sources of information for health care providers and patients.

Methods

We performed a cross-sectional questionnaire survey among patients of 59 general practitioners in the German Federal State Saxony-Anhalt in 2005 in order to collect detailed information on all drugs of patients maintained on more than three drugs.

Results

The response rate was 82.1% (n=905) and 3,158 drugs (tablets and dragées) were included in the analyses. Of all drugs, 24.1% were split (762 of 3,158): 8.7% of all split tablets were unscored (66 of 762) and 3.8% of all split tablets were not allowed to be split (29 of 762). Tablets of the higher price categories and higher strengths were twice as likely to be split. Only 22.5% of the SPCs (9 of 40) of the split unscored tablet brands contained explicit information on divisibility and only 36.4% of the PLs (8 of 22) of the split brands that were not allowed to be split stated that splitting was not appropriate.

Conclusion

The splitting of tablets in primary care is a frequent habit likely driven by medical and economic considerations. Almost 1% of all tablets are split that must not be fragmented. However, the SPC and PL provide only limited information on divisibility stressing the need to improve this information promptly to avoid medication errors.

Keywords

Package leaflet Summary of product characteristics Survey Tablet splitting 

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • R. Quinzler
    • 1
  • C. Gasse
    • 1
  • A. Schneider
    • 2
  • P. Kaufmann-Kolle
    • 3
  • J. Szecsenyi
    • 2
  • W. E. Haefeli
    • 1
  1. 1.Department of Internal Medicine VI, Clinical Pharmacology and PharmacoepidemiologyUniversity of HeidelbergHeidelbergGermany
  2. 2.Department of General Practice and Health Services ResearchUniversity of HeidelbergHeidelbergGermany
  3. 3.AQUA-Institute for Applied Quality Improvement and Research in Health CareGöttingenGermany
  4. 4.Klinisk Epidemiologisk AfdelingÅrhus UniversitetshospitalÅrhus CDanmark

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