Abu-Geras Dana, Hadziomerovic Dunja, Leau Andrew, Khan Ramzan Nazim, Gudka Sajni, Locher Cornelia, Razaghikashani Maryam, Lim Lee Yong
Pharmacy, Centre for Optimisation of Medicines, School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia.
School of Mathematics and Statistics, University of Western Australia, Crawley, WA, Australia.
J Pharm Pharmacol. 2017 May;69(5):603-612. doi: 10.1111/jphp.12671. Epub 2016 Dec 28.
To examine factors that might affect the ability of patients to accurately halve tablets or measure a 5-ml liquid dose.
Eighty-eight participants split four different placebo tablets by hand and using a tablet splitter, while 85 participants measured 5 ml of water, 0.5% methylcellulose (MC) and 1% MC using a syringe and dosing cup. Accuracy of manipulation was determined by mass measurements.
The general population was less able than pharmacy students to break tablets into equal parts, although age, gender and prior experience were insignificant factors. Greater accuracy of tablet halving was observed with tablet splitter, with scored tablets split more equally than unscored tablets. Tablet size did not affect the accuracy of splitting. However, >25% of small scored tablets failed to be split by hand, and 41% of large unscored tablets were split into >2 portions in the tablet splitter. In liquid measurement, the syringe provided more accurate volume measurements than the dosing cup, with higher accuracy observed for the more viscous MC solutions than water.
Formulation characteristics and manipulation technique have greater influences on the accuracy of medication modification and should be considered in off-label drug use in vulnerable populations.
研究可能影响患者准确将药片对半分开或量取5毫升液体剂量能力的因素。
88名参与者用手并使用药片分割器将四种不同的安慰剂药片分开，85名参与者使用注射器和量杯量取5毫升水、0.5%甲基纤维素（MC）和1% MC。通过质量测量确定操作的准确性。
普通人群将药片分成相等部分的能力不如药学专业学生，尽管年龄、性别和既往经验并非重要因素。使用药片分割器时，将药片对半分开的准确性更高，有划痕的药片比无划痕的药片分割得更均匀。药片大小不影响分割的准确性。然而，超过25%的小的有划痕药片无法用手分开，41%的大的无划痕药片在药片分割器中被分成了超过两部分。在液体量取方面，注射器提供的体积测量比量杯更准确，对于更粘稠的MC溶液，观察到的准确性高于水。
制剂特性和操作技术对药物调整的准确性有更大影响，在弱势群体的超说明书用药中应予以考虑。
