Changes in Appearance of Medicine Effects Patient Adherence

A recent study found that individuals are more likely to stop taking their medication after a heart attack if the appearance of their medication changes without explanation [Ann Intern Med. 2014;161(2):96-103].

Aaron S. Kesselheim, MD, JD, MPH, and colleagues analyzed data on >11,000 patients who were prescribed common medications, including beta-blockers, statins, and angiotensin-converting-enzyme inhibitors.

In the study, in the year following a heart attack, nearly one-third of patients had a change in pill color or shape. Of the patients whose medication’s appearance had changed, they were 30% to 70% more likely to stop taking their medication compared with patients whose medication’s appearance remained the same.

Patients whose pills changed in shape were especially likely to stop taking them, according to the researchers. The authors found that statins changed in appearance the most often compared to other drugs in the study.

Dr. Kasselheim noted that it is of particular importance that patients adhere to medications prescribed during the first year after a heart attack in order to reduce the risk of additional heart problems. He noted that changing or stopping medications during the first year is a common problem in this patient population, noting that in some reports, there is a 50% chance of nonaherence to prescribed drugs among patients with cardiovascular diseases.

Dr. Kasselheim advises that physicians and pharmacists prepare patients ahead of time to make the transition to the medication’s new appearance easier. Patients should also ask their pharmacist why their pills look different, according to Dr. Kasselheim.

The FDA has approved generic drugs as interchangeable, and changes based on appearance for a generic drug should not have any effect on the safety or efficacy of a drug, according to Dr. Kasselheim.

In the general population, 20% to 30% of prescriptions are never filled, and 50% are not continued as prescribed, according to the Centers for Disease Control and Prevention.—Kerri Fitzgerald

Source: Thomson Reuters. 2014; Heart patients might go off medication after changes in pill appearance.