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J Gen Intern Med. 2019 Mar;34(3):420-428. doi: 10.1007/s11606-018-4791-1. Epub 2019 Jan 10.

A Survey of Patients' Perceptions of Pill Appearance and Responses to Changes in Appearance for Four Chronic Disease Medications.

Author information

1
Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. asarpatwari@bwh.harvard.edu.
2
Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
3
Center for Bioethics and Humanities, University of Colorado, Denver, CO, USA.
4
Epidemiology, Optum, Ann Arbor, MI, USA.
5
Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA.

Abstract

BACKGROUND:

Generic versions of a drug can vary in appearance, which can impact adherence.

OBJECTIVE:

To assess the preferences, perceptions, and responses of patients who experienced a change in the appearance of a generic medication.

DESIGN:

Cross-sectional survey of patients from a large commercial health plan.

PARTICIPANTS:

Adults receiving generic versions of lisinopril, fluoxetine, lamotrigine, or simvastatin who experienced a change in the color or shape of their pills between March 2014 and November 2015.

MAIN MEASURES:

Likert-scale responses to questions concerning perceptions of generic drug safety and effectiveness, reliance on and preferences for pill appearance, and responses to pill appearance changes. Multivariable logistic regression-modeled predictors of seeking advice and adjusting use following a pill appearance change.

KEY RESULTS:

Of 814 respondents (response rate = 41%), 72% relied on pill appearance to ensure they took the correct medication. A similar percentage wanted their pills to remain the same color (72%), shape (71%), and size (75%) upon refill, but 58% would not have paid a $1 premium on a $5 co-pay to ensure such consistency. Most respondents (86%) wanted their pharmacists to notify them about pill appearance changes, but only 37% recalled such notification; 21% thought they received the wrong medication, and 8% adjusted medication use. Younger respondents (18-33 vs. 50-57 years) were more likely to seek advice (odds ratio [OR] = 1.91; 95% confidence interval [CI],1.02-3.59), and respondents with lower household income (< $30,000 vs. > $100,000) were more likely to adjust medication use (OR = 3.40; 95% CI,1.09-10.67).

CONCLUSIONS:

Requiring uniform pill appearance may help increase adherence but presents challenges. Standardized pharmacy notification and education policies may be a more feasible short-term solution.

KEYWORDS:

chronic diseases; medication adherence; pill appearance; survey

PMID:
30632102
DOI:
10.1007/s11606-018-4791-1

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