Patients Stop Using Drugs When Color, Shape Of Pill Changes

Lawrence LeBlond for – Your Universe Online
Nearly 70 percent of the medications prescribed to patients come in the form of generic prescriptions. However, even though these off-brand drugs are chemically equivalent to their brand-name counterparts, most differ physically (different shapes and colors). And a new study has found that patients are over 50 percent more likely to stop taking their meds when the generic version doesn´t match the brand name.
Researchers from Brigham and Women´s Hospital (BWH) note this has dire implications, as stopping medications based purely on how the drug looks could lead to potentially adverse clinical effects.
“Pill appearance has long been suspected to be linked to medication adherence, yet this is the first empirical analysis that we know of that directly links pills´ physical characteristics to patients´ adherence behavior,” explained study author Aaron S. Kesselheim MD, JD, MPH, assistant professor of medicine in the Division of Pharmacoepidemiology and Pharmacoeconomics (DPP) at BWH. “We found that changes in pill color significantly increase the odds that patients will stop taking their drugs as prescribed.”
Using a national database, the BWH team tracked prescriptions for eight anti-epileptic drugs from 2001 to 2006, noted patients who stopped filling them, and checked to see if the medications´ colors had changed. Publishing their work in JAMA Internal Medicine, the researchers tracked 11,472 patients who stopped filling their prescriptions, compared to over 50,000 controls who continued filling theirs.
They discovered that 53 percent of patients who had epilepsy and 27 percent of people taking the same prescriptions for other reasons were more likely to stop taking their pills if the color had changed. A change in shape also affected the patients´ use of meds, but not as statistically significant as changing color.
The findings of this study offer an important take-home message for physicians, pharmacists and patients, said Kesselheim.
“Patients should be aware that their pills may change color and shape, but that even differently-appearing generic drugs are approved by the FDA as being bioequivalent to their brand-name counterparts and are safe to take. Physicians should be aware that changes in pill appearance might explain their patients´ non-adherence,” Kesselheim said in a statement.
“I think we´ve identified another hurdle to medication adherence and a relatively easy way to fix it,” he told the New York Times´ Nicholas Bakalar. “Require that brand names and generics should look alike. The color of a pill does have clinical relevance.”
Researchers acknowledge that there are many aspects when it comes to medication adherence, but suggest that taking appropriate steps to permit (or require) similarity in pill shape and color between generic drugs and their brand-name counterparts may help keep patients on their medications.
If anything, “pharmacists should make a point to tell patients about the change in color and shape when they change generic suppliers,” Kesselheim concluded.

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