Melo Vivianne V, Pereira Gessyka R, Soares Amanda Q, Silva Izabel C, Taveira Stephania F, Cunha-Filho Marcilio, Marreto Ricardo N
MSc. Laboratory of Nanosystems and Drug Delivery Devices (NanoSYS), School of Pharmacy, Federal University of Goiás. Goiânia, GO (Brazil).
PhD, MSc. Pharmacy Service, University Hospital of the Federal University of Goiás. Goiânia, GO (Brazil).
Pharm Pract (Granada). 2020 Apr-Jun;18(2):1910. doi: 10.18549/PharmPract.2020.2.1910. Epub 2020 Jun 2.
Although a highly common practice in hospital care, tablet splitting can cause dose variation and reduce drug stability, both of which impair drug therapy.
To determine the overall prevalence of tablet splitting in hospital care as evidence supporting the rational prescription of split tablets in hospitals.
Data 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.
The 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.
The 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.
尽管片剂分割在医院护理中是一种非常常见的做法，但它可能会导致剂量变化并降低药物稳定性，这两者都会损害药物治疗效果。
确定医院护理中片剂分割的总体发生率，为医院合理开具分割片剂处方提供证据支持。
对从住院患者处方中收集的数据进行描述性统计分析，用于计算片剂分割的总体发生率以及市场上有至少一种低强度片剂可供使用的分割片剂的百分比。还评估了总体发生率与患者性别、年龄和医院科室之间的关联。使用商用分割器进行实验室测试的结果，可计算出分割片剂的质量损失、质量变化和脆碎度。
片剂分割的总体发生率为4.5%，处方分割的片剂中有78.5%在市场上有至少一种低强度片剂。片剂分割的发生率与患者年龄和医院科室显著相关。实验室测试显示，质量损失和变化的平均值分别为8.7%（标准差1.8）和11.7%（标准差2.3），两者均受到包衣和刻痕的显著影响。实验室测试数据表明，14种片剂中有12种的质量在至少一个检测参数上出现偏差。
不必要的片剂分割比例较高，这表明需要更定期、合理地更新医院的标准药品清单。此外，不适当的分割行为表明需要开发带有功能性刻痕的片剂。
