Practices and perceptions around splitting of carbidopa/levodopa tablets: a survey of patients and neurologists.

BACKGROUND

Carbidopa/levodopa (CD/LD) remains the primary treatment for Parkinson's disease (PD) motor control symptoms. With progressing disease, for better symptom management, patients often split immediate-release CD/LD tablets-research on this practice is limited.

OBJECTIVE

Survey patients with PD/caregivers, and neurologists on CD/LD pill-splitting practices and motor complications' impact on quality of life (QoL).

METHODS

We surveyed 101 patients/caregivers and 120 neurologists.

RESULTS

All agreed that motor control symptoms substantially affect QoL, particularly as PD progresses. 47% of patients surveyed halved immediate-release CD/LD tablets, and 27% fragmenting them further, with 27% and 18% finding it easy and accurate, respectively. Pill splitters reported longer disease duration, more advanced PD, worse motor fluctuations/dyskinesia control, and QoL. Neurologists reported dissatisfaction with CD/LD treatments for advanced disease, noting 44.9% of patients split tablets with, and 21.9% without, physician recommendation.

CONCLUSIONS

Pill splitting is common but burdensome and imprecise. Further research is needed to evaluate clinical impact.