The rationale of scored tablets as dosage form

The aim of the study was to get insight into the rationale of scored tablets. This was pursued by studying patient's reasons for subdividing ("breaking") scored and unscored tablets. Patients who picked up their prescriptions in 5 community pharmacies in The Netherlands were questioned. Two-hundred and seventy-five prescriptions were studied. Of all dispensed tablets, 31% were subdivided, mostly because a dose that needed subdivision was prescribed. However, 30% were subdivided upon the initiative of the patient himself: 13% for ease of swallowing and 17% because the patient chose to take a lower dose. Even unscored tablets were subdivided: because the dose prescribed was half the tablet dose (6%), for ease of swallowing (1%) and the wish of the patient to take a lower dose (3%). It was also inquired about the patient's perception of the ease of subdivision of scored tablets. Problematic subdivision of scored tablets was reported in 55% of the cases, 42% of which was attributed to a disfunctioning score line. We also studied the possibility to prescribe and dispense other medicinal products as alternatives for tablets that needed to be subdivided. For 46% a dosage form with a lower dose was on the market, for 54% it was not. We conclude that scored tablets still fulfil an important role. Even when lower dosed tablets would become available, there remains a substantial wish of patients to subdivide tablets for ease of swallowing and adapting the dose. Improving the functioning of score lines may be a more practical approach than banning this dosage form.