Does splitting a tablet obtain an accurate dose? A systematic review and meta- analysis

Abstract

The requirement to divide tablets into two or more doses in order to optimize medication for specific patients has led to widespread tablet
splitting. Problems may develop if a tablet is divided in an uneven manner.
The goal of the study was to provide a comprehensive review of the research on how tablet splitting affects dosage accuracy.
Study inclusion criteria were studies published before January 2020 that examined the impact of tablet splitting on dosage accuracy and were
located using a search of MEDLINE, EMBASE, CINAHL, and Cochrane. Any medication study in which the pill was broken might be considered. The
screening and data extraction were done by two separate reviewers. There have been meta-analyses done to see whether pill splitting affects how
well a dosage works. (Project number: CRD42018106252 at PROSPERO) Of the 25 studies considered, 16 looked at how tablet splitting affected
tablet weight, 1 looked at how it affected drug concentration, and 8 looked at both. The weight and drug content of split tablets were found to vary
by just a little amount in a meta-analysis (0.87% and 0.24%, respectively, 95% confidence range 0.63%-1.11% and 95% confidence interval
0.06%-0.43%). There was considerable discrepancy across trials with regards to weight, but not with regards to drug content fluctuation (I2 =.50,
vs.1%). Tablet features and the technique used to divide the tablets both had a role in determining how well they worked.
This investigation reveals that the weight and drug content variance is modest independent of the technique and tablet properties, even if tablet
splitting may affect dosage accuracy. To further understand the function of tablet splitting on dosage accuracy, more research is required to
measure medication plasma concentrations as well as the effect on patient health outcomes including blood pressure and cholesterol levels.