A study showing that drugs distributed in blister packages rather than in bottles increase the likelihood that medications will be taken properly, could help encourage the take-up of unit-dose packaging in the US market, reports Phil Taylor.
The study found that patients taking the high blood pressure medication lisinopril were more likely to have their prescriptions refilled on time if the medication came in a blister package rather than as loose tablets in a bottle. In this case, the blister package, supplied by Cardinal Health, clearly started the day on which to take each pill.
Moreover, diastolic blood pressure was reduced in nearly half of the patients who received the drug in a blister package, compared to fewer than 20 per cent of those participants who received bottles of medication. "This suggests that a better system of packaging for medications helped people take their medications properly, said Philip Schneider, the study's lead author and a clinical professor of pharmacy at Ohio State University.
In the US, plastic bottles still account for the single largest share of the total pharmaceutical packaging market, at 32 per cent in 2003, because of their perceived ease of use and cost effectiveness benefits. Western European countries tend to have a higher rate of unit-dose packs, because there are requirements to supply drugs in this format in the legislature. The US is gradually following suit, however, with unit dose packaging becoming a requirement for institutional drugs.
The study included 88 adults who were 65 and older. All of the participants had hypertension, indicated by a blood pressure reading of 140/90 or higher, and were treated with lisinopril (AstraZeneca's Prinivil) during the study.
More than half (48) of the participants were randomly assigned to receive a 28-day supply of medication in the blister package, while the rest of the patients (40) received a traditional bottle of loose tablets. The study lasted nearly two years, and participants were enrolled for 12 months each. During their time in the study, the patients saw their physician once every six months and their pharmacist about once each month for refills.
Results showed that 14 per cent more participants who received their medication in a blister pack with the pill calendar format had their prescriptions refilled on time. Also, the researchers noted that 48 per cent of the patients in this group had lower diastolic blood pressure after 12 months, compared to only 18 per cent of the patients who received their medications in a bottle.
While a few patients complained that the blister packaging was too difficult to open, no other adverse events were noted.
"If people can tell whether or not they have taken their medication on a particular day, it improves the chance that they will take the medicine properly," Schneider said. "It's often hard to put all of the information a patient may need on to one container."
"As the federal government develops policies for the new prescription drug benefit for older adults, there is a need to consider how these medications are distributed," Schneider continud. "Although blister packs are slightly more expensive than a bottle, people often forget to take their bottled medications, or get confused on how to take them properly. Offering long-term medications in this type of packaging could ultimately save millions of dollars."
Schneider presented the findings yesterday at an American Heart Association conference.