Tablets are the most common type of solid dosages, made to resist attrition and fracture. When a tablet contains too high dose, it is necessary to split it and use only half at a time. The most common ways to split tablets are: breaking it by hand, using a tablet-splitter, a knife or scissors. The aim with this paper is to show how pharmacy customers split tablets when they must and which splitting methods they prefer. The data was collected by interviewing all pharmacy customers with a prescription dosage where the tablets could be split. 171 interviews were conducted during a two-week period at eight community pharmacies throughout Sweden. 89% of the customers with a prescription where the tablets could be split, did so. 49% broke the tablets by hand, 31% used a knife and only 14% used a tablet-splitter. Psycholeptics (ATC group N05) tablets were split most frequently (31%), agents acting on the Renin-angiotensin system (ATC group C09) (13%), and psycoanaleptics (ATC group N06) (11%). Once the patients have found a way of splitting tablets they are comfortable with, they tend to stick to that method. Only 16% reported that they had tried more than one method. When asked if they manage to split the tablets into even doses or if they took the larger part of an unevenly split tablet, 60% answered yes; only 6.5% were worried that the difference in dose size would affect their medication. A few patients (13.5%) stated that they would like tablets with a lower dose, so that they don’t have to split them. Most studies revealed that elderly can take lower drug doses. We found that 116 (68%) of the patients in our study were elderly and need to divide their tablets. Only 4 patients refused to split their tablets, acting against the doctor’s recommendation on the prescription. We were unable to ascertain why, but it might be due to the drug’s side effects. 2.4% of all pharmacy customers who collected drugs during this two-week period had a prescription with splittable tablets. If we generalize this result to all of Sweden, around 40000 individuals use splittable tablets.

Bakgrund: Läkemedelsordinationer som kräver delning av tabletter är vanligt och förekommer vid ca. 10 % av expedierade recept. Tabletter kan vara svåra att dela, ge smulor eller delas i olika stora delar vilket kan påverka patientens följsamhet till behandlingen och behandlingsresultat. Syftet med studien var att undersöka hur patienterna gör när den förskrivna tablettberedningen måste delas, samt hur kvarvarande delad tablett förvaras. Metod: Intervjustudie med apotekskunder som har ordination vilket kräver delning av tablettberedningar. Resultat: Av 7677 apotekskunder med recept, vid åtta apotek, hade 188 (2,4 %) dosering som krävde tablettdelning. 171 kunder deltog i intervjustudien angående upplevelser av tablettdelning. 66 % av deltagarna (113/171) var >65 år. 49 % (75/153) delade tabletten med fingrarna, 31 % (47/153) med kniv och 14 % (22/153) med tablettdelare. Sax, tång eller tänderna användes av 6 % (9/153). Fyra respondenter delade inte. Den kvarvarande tablettdelen förvarades i dosett av 50 % (69/139), 37 % (51/139) lade tillbaka tablettdelen i förpackningen, 8 % (11/139) använde en skål, fat eller ett glas. Slutsats: Hälften av respondenterna delade med verktyg, vilket tyder på att tabletterna var svåra att dela för hand. Andelen äldre och deras upplevelse av att tabletterna var små och svårhanterliga kan vara orsaken. Det övervägande användandet av dosett för förvaring av tabletthalvorna, kan bero på att fler läkemedel användes, vilket är vanligare vid högre ålder och förenklar läkemedelshanteringen. / Prescriptions that requires splitting tablets is common and occurs at 10 % of all prescriptions in Sweden. Causes why doctors prescribe dosages with split tablets could be the absence of appropriate strength when children and elderly people need lower dosages than those available on the market. Other reasons for splitting tablets can be problem with swallowing large tablets and economic considerations. Not all tablets are intended to be split and scored tablets do not always mean that the tablet can be split in two equal parts. Difficulties in splitting tablets, crumbling or different size of the tablet parts could affect the patient’s compliance and the outcome of the treatment. The aim of this study was to examine how the pharmacy customers do when the tablet must be split and how the remaining divided tablet is stored. Among 7677 customers with prescriptions, visiting eight pharmacies in Sweden, 188 (2,4%) were splitting tablets in half. Out of them 171 (2/3 women) accepted to participate in interviews to assess pros and cons in tablet splitting. 66% (113/171) of the respondents was at the age of 65 or older. 49% (75/153) split their tablets between the fingers, 31% (47/153) used a knife, 14% (22/153) used a tablet splitter. Scissor, pliers and teeth were used by 6% (9/153). Four respondents didn´t split their tablets. Medication for heart-/vessels and psychotropic drugs was used by 81% (139/171). The most commonly divided drug was Imovane® 7,5 mg (12%, 20/171), 50% (10/20) used a tool for splitting it, the rest used their fingers and many of them got different size of the parts. The split tablets were stored in a dosett for 50% (69/139) of the respondents, 37% (51/139) put it back in the packaging, 8% (11/139) laid it in a bowl, on a plate or in a glass. Half of respondents used a tool, which indicate for difficulties in splitting. The proportion of older people and experience of small and difficult broken tablets could be a reason. The major use of dosett for storage, may be due to the use of several drugs, which are more common in older ages and facilitates the drug treatment.