Healthy Skepticism Library item: 12665

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Schneider PJ, Murphy JE, Pedersen CA.
Impact of medication packaging on adherence and treatment outcomes in older ambulatory patients.
J Am Pharm Assoc (2003) 2008 Jan-Feb; 48:(1):58-63
http://www.ncbi.nlm.nih.gov/pubmed/18192132

Abstract:

OBJECTIVE: To evaluate medication adherence and treatment outcomes in elderly outpatients using daily-dose blister packaging (Pill Calendar) compared with medications packaged in bottles of loose tablets. DESIGN: Randomized controlled trial. SETTING: Ambulatory care clinics at Ohio State University Medical Center, Columbus; University of Arizona Health Science Center, Tucson; and Riverside Methodist Hospital Family Medicine Clinic, Columbus, Ohio, from July 1, 2002, to December 31, 2004. PATIENTS: 85 individuals 65 years of age or older being treated with lisinopril for hypertension. INTERVENTION: Patients were randomly assigned to receive lisinopril in either daily-dose blister packaging (Pill Calendar) or traditional bottles of loose tablets. MAIN OUTCOME MEASURES: Adherence was assessed by prescription refill regularity and medication possession ratio (MPR). Treatment outcome and use of medical services were assessed by medical record review of blood pressure and morbidity associated with poorly controlled hypertension. RESULTS: Patients receiving lisinopril in the daily-dose blister packaging (Pill Calendar) refilled their prescriptions on time more often (P = 0.01), had higher MPRs (P = 0.04), and had lower diastolic blood pressure (P = 0.01) than patients who had their medications packaged in traditional bottles of loose tablets. CONCLUSION: Providing medications in a package that identifies the day each dose is intended to be taken and provides information on proper self-administration can improve treatment regimen adherence and treatment outcomes in elderly patients.

Keywords:
Aged Ambulatory Care Antihypertensive Agents/therapeutic use* Arizona Blood Pressure/drug effects Drug Labeling/methods Drug Packaging* Female Humans Hypertension/drug therapy* Lisinopril/therapeutic use* Male Ohio Patient Compliance* Time Factors Treatment Outcome

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909