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Altering Your Medication in Parkinson’s Disease: Pill-splitting

Posted Mar 05 2011 2:28pm

A study released January 15th of this year, says pill-splitting can be a dangerous hobby.  Now, this isn’t talking about sharing pills, the ‘one for you, one for me’ activity, but the literal breaking apart of a single pill to more easily digest or make the bottle go further type of pill-splitting.

According to Maureen Salamon of HealthDay, Belgian researchers have discovered that “nearly one-third of split pill fragments deviated from recommended dosages by 15% or more.”  A study was conducted in which five volunteers were given three tools in which to split their pills – a pill-splitting tool, a pair of scissors, and a regular kitchen knife.  You know – the regular pill-splitting tools most people have on hand.

It was reported that from this method of splitting pills, another 25% of the recommended dosages differed from the original dosage prescribed.  Even when using a device invented to do the job more accurately (a pill-splitting designed just for splitting pills), in most cases, a 15%-25% margin of error occurred. This was determined by weighing each pill fragment before and after splitting to determine the difference.

Charlotte Verrue of the Ghent University of Belgium, who was part of this project, stated that nursing homes use this practice all the time and it usually doesn’t create a problem, however consequences could occur if a larger percentage of difference were to occur, which in splitting pills can be quite common.

The study came about when nurses who deal with patients in nursing homes asked Verrue what the best method of practice for splitting pills was, since many dosages given in these facilities require splitting.

Verrue said that of the five people who volunteered, only one had prior experience in splitting pills and she said that this is the norm for nursing professionals in nursing homes (they just don’t have that prior experience in pill-splitting).  Several tablets were chosen of different shapes and sizes that are commonly prescribed for Parkinson’s disease, heart problems and arthritic conditions (common nursing home ailments).  These tablets (approximately 3,600), were quartered and/or halved.  Of the 3,600 pills to be split, three varieties were unscored, three had only one score line, and the remainder of the pills split had two lines.

Verrue believes that nurses should be the ones to perform this task for patients, but they don’t necessarily have the training in which to do it.

Nancy Mason, a professor of the University of Michigan, claimed she has never heard of such research. She did however state that it was a ‘unique study’ and if you were to give it some thought, wasn’t at all surprising.

Both Verrue and Mason agreed that deviating from the recommended dosage of certain pills can succumb to critical problems, such as patients experiencing seizures, irregular heartbeat, and blood clots.

To ensure that the act of pill-splitting becomes unnecessary, Verrue called on drug companies to begin producing more options for dosages and liquid alternatives.  Resistance from drug companies, however, will be expected if profits are not in the picture and just might counter attack her suggestion with that of nurses being required to begin a Pill-splitting 101 course as part of their education.  Until this all gets figured out, watch your pill-splitting techniques, fellow PD’ers.  You want to make sure you’re getting the entire amount you need.  You don’t want to be short-changing yourself on that carbidopa/levodopa dosage now, do you?

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