Issue link: https://www.e-digitaleditions.com/i/316458
Tablets & Capsules May 2014 11 and confusion, ("I didn't know how many to take."). In - tentional reasons include "fear of side effects," and "drug cost," lack of perceived need ("I feel fine"), and inconve- nience [9]. The role of packaging While improving adherence offers huge rewards, suc- cess requires combining packaging research with behav- ioral research. It seems certain that most of the uninten- tional reasons for people not taking their medications can be addressed with better packaging. Packaging could also address some of the intentional reasons, such as "inconve- nience" and "confusion" by removing some degree of uncertainty. One study—the Federal Study for Adherence to Medications in the Elderly (FAME) —generated interest- ing and promising results. In that study, conducted by the Department of Pharmacy at Walter Reed Army Medical Center, Bethesda, MD, elderly patients showed signifi- cantly better outcomes when their multiple medications were bundled into easy-to-use packages. As the authors described it, the FAME study "was a mul- tiphase, single-center study of the efficacy of a comprehen- sive pharmacy care program, which included patient edu- cation and an adherence aid (medications custom- packaged in blister packs) to improve medication adher- ence among military healthcare beneficiaries aged 65 years or older who were prescribed at least four chronic medica- tions per day. We further tested the impact of the program on blood pressure (BP) and low-density lipoprotein choles- terol (LDL-C), biomarkers of the efficacy of pharma- cotherapy to lead to optimal cardiovascular health out- comes." The conclusions of this 200-patient study were a marked improvement in adherence and improved measur- able outcomes in the patients participating in the trial [10]. The blister card used in the study, organized for a 31- day month, made it easy for patients to know when to take their medications. It had no features to record or notify the physician or pharmacist regarding the patient's use of the medications, but it did significantly improve the organization and eliminated the confusion many elderly patients faced with multiple medications. It is certainly an improvement on the do-it-yourself plastic organizer. Pouches can also improve adherence by placing all of a person's medications in a convenient package plainly labeled. They provide the same simplicity of a blister pack and, like individual or multiple blisters, are easily portable. Given this background, it is unclear why more insur- ance companies and government-managed healthcare systems are not pushing to expand the use of packaging that could significantly reduce healthcare costs. The Healthcare Compliance Packaging Council (HCPC), which promotes the benefits of adherence, in April co- sponsored a 1-day event, RxAdherence, dedicated to the topic. At the event, HCPC recognized Noven Pharma - ceuticals' blister package as its "Compliance Package of the Year." The adherence-promoting blister uses Dosepak from MeadWestvaco, Richmond, VA, and was packaged at Packaging Coordinators, Rockford, IL. At the American Pharmacists Association Conference in March, Prof. Sharrel Pinto of the University of Toledo College of Pharmacy and Pharmaceutical Sciences pre- sented results of a study that evaluated patient confidence in self-administering their medications using a blister card filled and sealed by the pharmacy versus using self-orga- nized vials, boxes, and pouches. According to a press Example of blister packaging used in the FAME study, which showed how simplifying the administration of multiple medications boosted patient adherence. The Healthcare Compliance Packaging Council named Noven Pharmaceuticals' blister package "Compliance Package of the Year." Pouches that hold all of a person's medications are a simple, convenient package. c-Bauerart_8-13_Masters 5/14/14 10:13 AM Page 11