Kanika Chaudhri BMedSci (Hons), MD, Madeleine Kearney BMedSci, Gian Luca Di Tanna PhD, Sonali R. Gnanenthiran MBBS, PhD, Richard O. Day MBBS, PhD, Anthony Rodgers MBBS, PhD, Emily R. Atkins PhD
{"title":"把片剂分开能得到准确的剂量吗?系统回顾和荟萃分析","authors":"Kanika Chaudhri BMedSci (Hons), MD, Madeleine Kearney BMedSci, Gian Luca Di Tanna PhD, Sonali R. Gnanenthiran MBBS, PhD, Richard O. Day MBBS, PhD, Anthony Rodgers MBBS, PhD, Emily R. Atkins PhD","doi":"10.1002/jppr.1843","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Tablet splitting is a widely prevalent practice resulting from the need to alter doses into two or more parts and optimise medicine in individual patients. If a tablet is split unequally problems may arise.</p>\n </section>\n \n <section>\n \n <h3> Aim</h3>\n \n <p>The aim of the study was to summarise the literature measuring the effect of tablet splitting on dose accuracy.</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>MEDLINE, EMBASE, CINAHL and Cochrane were searched and studies published prior to January 2020 investigating the effect of splitting tablets on dose accuracy were included. Studies investigating any drug, where the tablet was split, were potentially eligible. Two independent reviewers conducted the screening and extracted the data. Meta-analyses assessing the effect of tablet splitting on dose accuracy were performed. (Study registration: PROSPERO CRD42018106252).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of 25 included studies, 16 examined the effect of tablet splitting on weight of the tablet, one on drug concentration and eight examined both. Meta-analysis found small variation between split tablets (0.87% weight variation, 95% confidence interval 0.63%–1.11% and 0.24% drug content variation, 95% confidence interval 0.06%–0.43%). There was some inconsistency across trial results for weight but not for drug content variation (<i>I</i><sup>2</sup> 50% and <i>I</i><sup>2</sup> 1%, respectively). Splitting method and tablet characteristics were predictors of accuracy.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Although tablet splitting may influence dose accuracy, this analysis suggests that the weight and drug content variation is minimal, regardless of method and tablet characteristics. Additional studies, such as those examining drug plasma concentrations and effect on patient health outcomes for example blood pressure and cholesterol levels, are needed to better understand the role of tablet splitting on dose accuracy.</p>\n </section>\n </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"52 6","pages":"411-421"},"PeriodicalIF":1.0000,"publicationDate":"2023-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1843","citationCount":"0","resultStr":"{\"title\":\"Does splitting a tablet obtain an accurate dose? A systematic review and meta- analysis\",\"authors\":\"Kanika Chaudhri BMedSci (Hons), MD, Madeleine Kearney BMedSci, Gian Luca Di Tanna PhD, Sonali R. Gnanenthiran MBBS, PhD, Richard O. Day MBBS, PhD, Anthony Rodgers MBBS, PhD, Emily R. 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Does splitting a tablet obtain an accurate dose? A systematic review and meta- analysis
Background
Tablet splitting is a widely prevalent practice resulting from the need to alter doses into two or more parts and optimise medicine in individual patients. If a tablet is split unequally problems may arise.
Aim
The aim of the study was to summarise the literature measuring the effect of tablet splitting on dose accuracy.
Method
MEDLINE, EMBASE, CINAHL and Cochrane were searched and studies published prior to January 2020 investigating the effect of splitting tablets on dose accuracy were included. Studies investigating any drug, where the tablet was split, were potentially eligible. Two independent reviewers conducted the screening and extracted the data. Meta-analyses assessing the effect of tablet splitting on dose accuracy were performed. (Study registration: PROSPERO CRD42018106252).
Results
Of 25 included studies, 16 examined the effect of tablet splitting on weight of the tablet, one on drug concentration and eight examined both. Meta-analysis found small variation between split tablets (0.87% weight variation, 95% confidence interval 0.63%–1.11% and 0.24% drug content variation, 95% confidence interval 0.06%–0.43%). There was some inconsistency across trial results for weight but not for drug content variation (I2 50% and I2 1%, respectively). Splitting method and tablet characteristics were predictors of accuracy.
Conclusion
Although tablet splitting may influence dose accuracy, this analysis suggests that the weight and drug content variation is minimal, regardless of method and tablet characteristics. Additional studies, such as those examining drug plasma concentrations and effect on patient health outcomes for example blood pressure and cholesterol levels, are needed to better understand the role of tablet splitting on dose accuracy.
期刊介绍:
The purpose of this document is to describe the structure, function and operations of the Journal of Pharmacy Practice and Research, the official journal of the Society of Hospital Pharmacists of Australia (SHPA). It is owned, published by and copyrighted to SHPA. However, the Journal is to some extent unique within SHPA in that it ‘…has complete editorial freedom in terms of content and is not under the direction of the Society or its Council in such matters…’. This statement, originally based on a Role Statement for the Editor-in-Chief 1993, is also based on the definition of ‘editorial independence’ from the World Association of Medical Editors and adopted by the International Committee of Medical Journal Editors.