Using a Data Warehouse to Monitor Clinical Outcomes Associated with Simvastatin Tablet Splitting

Abstract

A data warehouse was used to monitor therapeutic outcomes for a simvastatin tablet-splitting initiative. The data included prescription and laboratory information for all patients taking simvastatin between October 1, 1998 and February 28, 2003. Among 44,038 patients receiving simvastatin, the low-density lipoprotein (LDL) levels of 194,213 patients were reported. The tablet-splitting initiative was started in April 1999 and 5,683 patients were converted from whole to half tablets. The average LDL for these patients decreased by 15 mg/dL. A subset of patients (464 or 8.1%) had an increase in LDL greater than 10% and were above levels established in therapeutic guidelines. Based on the findings, concern about tablet splitting is most warranted during the initial period, when patients are switched from whole to split tablets. The economic benefit was more than $300,000 per year at our facility. Simvastatin tablet splitting appears to be an effective cost savings measure with little associated risk.

Avaliação da influência de múltiplos fatores envolvidos na partição de comprimidos

“…Concerning to modified-release tablets, studies using verapamil sustainedrelease tablets did not find statistics differences in bioavailability between split and whole tablets (76,77). A study using theophylline slow-release tablet showed faster absorption and higher plasma levels when volunteers took the halves instead whole (78).…”