Accuracy of tablet counts estimated by members of the public and healthcare professionals

OBJECTIVE Intentional and accidental drug intoxication is commonly seen in the emergency department. When treating intoxicated patients, accessing the amount of the ingested drug is crucial albeit often difficult. We investigated the accuracy of estimating tablet counts when participants were asked to hold tablets in their fists and hands (semi-quantitative terms). METHODS The widths and lengths of the participants' hands were measured. Then, the subjects were asked to hold 5-mm round, 10-mm round, 10-mm oval, and 15-mm elliptical tablets using their hands and fists and to estimate the number of tablets they were holding. Differences between the estimated and actual numbers of tablets were examined. RESULTS A total of 47 members of the public and 32 healthcare professionals were included in our study. In our analyses of the differences between the actual and estimated amounts of tablets held in the participants' hands and fists, we found that the actual amount was higher than the estimated amount for all tablet types and in both groups. When participants held the tablets in the same manner (handful or fistful), the differences between the actual and estimated amounts were greater for 5- than 15-mm-sized tablets (P<0.05). CONCLUSION The treatment of patients presenting with drug overdoses to the emergency department should be based on the assumption that the actual amount of drugs the patients ingested is likely greater than the amount the patients state.