Our data showed that endocrinologists, nephrologists and cardiologists were more likely to be associated with inappropriate splitting among all medical specialties. The probable reason may be that the majority of endocrinologists and nephrologists’ clients are patients with renal insufficiency, such that dose adjustment may be indicated, and pill splitting prescribed. Pharmacies should consider introducing new formulations with lower dosage strength for clinical demand. Old age was associated with a high risk of inappropriate pill splitting. The changing pathophysiology occurring with the aging process results in complex alterations to the pharmacokinetics and pharmacodynamics of medications. Clinical study has demonstrated that the 
effectiveness of drugs in geriatrics was substantially AbMole Crovatin metabolized in amounts lower than those standard references doses predicted. Therefore, prescribing the lowest effective doses of medications to older patients may avoid adverse drug events, minimize side effects, and increase compliance. However, this consideration of lowering doses for elders may cause an increased incidence of prescriptions involving tablet splitting, and contribute to a higher rate of inappropriate tablet splitting among older patients. This study has provided possible factors associated with inappropriate pill splitting for drugs with special oral formulations. The risk factors identified in this study may imply how to develop strategies for preventing medication errors for drugs with special oral formulations. The findings of this study are informative for the assessment and development of medication prescription policy in hospitals. In addition, identification and acknowledgement of risk factors regarding inappropriate pill splitting are needed to incorporate guidelines for medication safety and the educational curriculum of health professionals. This study has some limitations. First, the study was conducted in a single hospital over a short period of time, which limits the generalizability of our findings. Second, we only assessed the frequency of inappropriate pill splitting by drug formulation without analyzing associated clinical outcomes. Other characteristics of drugs such as score marking, size or shape of pills, and multiple ingredients were not taken into consideration. In addition, patient knowledge and ability to split tablets remain unknown. This could lead to underestimation of the frequency of inappropriate pill splitting. Finally, this cross-sectional study was only designed to identify associated risk factors; it cannot assess causality. However, our data provide insights into the nature of inappropriate prescription of pill splitting in outpatient clinics. Results from this study can provide an important foundation for future research. Another study from India has also reported significant association of Y402H among AMD patients.