title: Accuracy of tablet splitting and liquid measurements: an examination of who, what and how.
abstract: OBJECTIVE
  To examine factors that might affect the ability of patients to accurately halve tablets or measure a 5-ml liquid dose.
  
  
  METHODS
  Eighty-eight participants split four different placebo tablets by hand and using a tablet splitter, while 85 participants measured 5 ml of water, 0.5% methylcellulose (MC) and 1% MC using a syringe and dosing cup. Accuracy of manipulation was determined by mass measurements.
  
  
  RESULTS
  The general population was less able than pharmacy students to break tablets into equal parts, although age, gender and prior experience were insignificant factors. Greater accuracy of tablet halving was observed with tablet splitter, with scored tablets split more equally than unscored tablets. Tablet size did not affect the accuracy of splitting. However, >25% of small scored tablets failed to be split by hand, and 41% of large unscored tablets were split into >2 portions in the tablet splitter. In liquid measurement, the syringe provided more accurate volume measurements than the dosing cup, with higher accuracy observed for the more viscous MC solutions than water.
  
  
  CONCLUSIONS
  Formulation characteristics and manipulation technique have greater influences on the accuracy of medication modification and should be considered in off-label drug use in vulnerable populations.
authors.affiliation: Pharmacy, Centre for Optimisation of Medicines, School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia.
authors.forename: Dana
authors.initials: D
authors.lastname: Abu-Geras
authors.affiliation: Pharmacy, Centre for Optimisation of Medicines, School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia.
authors.forename: Dunja
authors.initials: D
authors.lastname: Hadziomerovic
authors.affiliation: Pharmacy, Centre for Optimisation of Medicines, School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Leau
authors.affiliation: School of Mathematics and Statistics, University of Western Australia, Crawley, WA, Australia.
authors.forename: Ramzan Nazim
authors.initials: RN
authors.lastname: Khan
authors.affiliation: Pharmacy, Centre for Optimisation of Medicines, School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia.
authors.forename: Sajni
authors.initials: S
authors.lastname: Gudka
authors.affiliation: Pharmacy, Centre for Optimisation of Medicines, School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Locher
authors.affiliation: Pharmacy, Centre for Optimisation of Medicines, School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia.
authors.forename: Maryam
authors.initials: M
authors.lastname: Razaghikashani
authors.affiliation: Pharmacy, Centre for Optimisation of Medicines, School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia.
authors.forename: Lee Yong
authors.initials: LY
authors.lastname: Lim
mesh_terms: D000293:Adolescent; D000328:Adult; D002626:Chemistry, Pharmaceutical / Q000379:methods; D002648:Child; D004339:Drug Compounding / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008747:Methylcellulose / Q000737:chemistry; D008875:Middle Aged; D012996:Solutions / Q000008:administration & dosage; D013607:Tablets / Q000008:administration & dosage* / Q000737:chemistry; D055815:Young Adult
chemical_list: D012996:Solutions; D013607:Tablets; D008747:Methylcellulose
keywords: accuracy; general population; liquid measurement; pharmacy students; tablet splitting