The participants split eight tablets of different shapes and sizes, prescribed for conditions such as Parkinson's disease, congestive heart failure and arthritis, into 3,600 separate quarters or halves. Three tablets were unscored, three had one score line and the rest had two.
"The splitting should indeed be performed by nurses, but it is not always the case in daily practice" because of staff shortages, Verrue said. "Moreover, I don't think that nurses have a specific training in tablet splitting."
Nancy Mason, a clinical associate professor of pharmacy at the University of Michigan, said she had never heard of research similar to this.
"I thought it was a unique study and when you think about it, not surprising at all," said Mason, also director of the university's Experiential Training Program in pharmacy. "It's very good information to know. As a pharmacist, I typically don't try to tell someone to split a pill. Even when it's scored, [the practice] still has issues."
Verrue and Mason said even minute dosage deviations of certain medications can cause critical problems, including drugs for irregular heartbeat, blood clots and seizures.
Verrue called on pharmaceutical companies to produce more dose options and liquid alternatives so pill-splitting becomes increasingly unnecessary. But she acknowledged that drug makers may resist such a move because it could hurt profits.
"I think that the smaller dosages are just not interesting enough from an economical perspective," Verrue said. "Providing liquid forms would be easier, I think, than providing a broader range of tablets."
The study, reported in the January issue of the Journal of Advanced Nursing, did not receive funding from any pharmaceutical companies.
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