Abstract
Tablet splitting practices have been shown to reduce the medication cost in many countries. This study was aimed to evaluate the tablet splitting practices among community pharmacists in Penang, Malaysia. A two-month cross-sectional descriptive survey was carried out in forty randomly chosen community pharmacies in Penang. The pharmacists were required to document all their tablet splitting recommendations during the study period. The data collected includes the appropriateness of the tablet splitting recommendations by pharmacists; the extent of communication between pharmacists and physicians when recommending tablet splitting; the physicians‟ and patients‟ acceptance towards the tablet splitting; and the documentation of cost-saving achieved from the tablet splitting. The result showed that the tablet splitting was recommended by 31.0% of the pharmacists who receives prescriptions eligible for this practice. Tablets of patent- protected innovator brands were more likely to be recommended for splitting. Majority (92.9%) of the splitting recommendations were appropriate except two cases which involve unscored combination tablet. The pharmacists requested consent from the physicians for 42.9% of the splitting recommendations and majority (91.7%) of the requests were accepted. Meanwhile, the patients‟ acceptance rate for splitting recommendation was 82.1%. Through acceptance of tablet-splitting, the patients‟ monthly expenses on drugs reduced by 36.5% and this correspond to a monthly saving of RM39.05 (US$10.30, US$1.00 = RM 3.80) per patient. The study concluded that the tablet splitting is not a common practice among the community pharmacists, however both the physicians and patients highly accept pharmacists‟ suggestion on splitting. The findings also revealed that tablet splitting can be used as a cost-containment measure for patient as well.