title: Issues around the Prescription of Half Tablets in Northern Switzerland: The Irrational Case of Quetiapine.
abstract: BACKGROUND
  Prescription of fragmented tablets is useful for individualisation of dose but includes several drawbacks. Although without score lines, the antipsychotic drug quetiapine was in 2011 the most often prescribed 1/2 tablet in discharge prescriptions at the University Hospital in Basel (USB, 671 beds). We aimed at analysing the prescription patterns of split tablets in general and of quetiapine in particular in Switzerland.
  
  
  METHODS
  All orders of community pharmacies for unit-of-use soft pouch blisters placed at Medifilm AG, the leader company in Switzerland for repackaging into pouch blisters, were analysed.
  
  
  RESULTS
  Out of 4,784,999 tablets that were repacked in 2012 in unit-of-use pouch blisters, 8.5% were fragmented, mostly in half (87.6%), and were predominantly psycholeptics (pipamperone 15.8%). Prescription of half quetiapine appears to be a Basel specificity (highest rates of fragments and half quetiapine).
  
  
  CONCLUSIONS
  Prescription of fragmented tablet is frequent. It represents a safety issue for the patient, and a pharmaceutical care issue for the pharmacist. In ambulatory care, the patient's cognitive and physical capacities must be clarified, suitability of the splitting of the tablet must be checked, appropriate aids must be offered, like a pill-splitting device in order to improve accuracy, and safe use of the drug must be ensured.
authors.affiliation: Pharmaceutical Care Research Group, Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056 Basel, Switzerland.
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Allemann
authors.affiliation: Hospital Pharmacy, University Hospital Basel, Spitalstrasse 26, 4031 Basel, Switzerland.
authors.forename: Delia
authors.initials: D
authors.lastname: Bornand
authors.affiliation: Internal Medicine, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland.
authors.forename: Balthasar
authors.initials: B
authors.lastname: Hug
authors.affiliation: Pharmaceutical Care Research Group, Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056 Basel, Switzerland.
authors.forename: Kurt E
authors.initials: KE
authors.lastname: Hersberger
authors.affiliation: Pharmaceutical Care Research Group, Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056 Basel, Switzerland.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Arnet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010595:Pharmacists; D000069348:Quetiapine Fumarate / Q000009:adverse effects / Q000627:therapeutic use*; D013557:Switzerland; D013607:Tablets / Q000627:therapeutic use*
chemical_list: D014150:Antipsychotic Agents; D013607:Tablets; D000069348:Quetiapine Fumarate