Background Tablet subdivision is often inaccurate, and patients and caregivers may find it difficult or painful to break tablets by hand. Tablet splitters can be used as a management strategy. In a former study, it was shown that tablets were more accurately subdivided by hand than using a tablet splitter for a best case operator and best case paracetamol tablet.1 In order to generalise these results to real life settings where medicines are commonly used by patients with suboptimal hand-eye function, such as in the elderly, it is essential to understand the relationship between hand-eye function and the acceptability and accuracy of different techniques for tablet subdivision. These results may help regulators to define patient centric criteria for tablet breaking.
Purpose To develop a test battery to study the relationship between people’s hand-eye function and the accuracy and acceptability of different techniques for tablet subdivision.
Material and methods First, a literature review was performed to determine which hand-eye functions could be relevant to tablet subdivision and to assemble these measurements into a draft test battery. Next, a pilot study (n = 30) was conducted among adults (21–90 years) to optimise the set-up of the test battery and to determine the validity and suitability of the hand-eye measurements. Tablet subdivision was performed with a best case tablet (paracetamol 500, round, uncoated) and two best case tablet splitters with a fundamentally different design (PillTool, HealthCare Logistic). Patient acceptability was assessed on a 10 point numeric rating scale and the preferred subdivision method.
Results Based on the literature review, measurement of finger circumference, pinch strength, grip strength, manual dexterity, active range of joint motion and near visual acuity were included. The pilot study resulted in minor adaptations of the order of tests in the battery and showed that the hand-eye measurements were comparable with normative data and likely related to the accuracy and acceptability of tablet subdivision.
Conclusion The test battery is suitable for use in a larger study.
References and/or Acknowledgements
van Riet-Nales DA, et al. The accuracy, precision and sustainability of different techniques for tablet subdivision. Int J Pharm 2014;466:44-51
References and/or AcknowledgementsNo conflict of interest.
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