Patients Centricity Canada

Jun 17, 2014 - Jun 18, 2014, Toronto

Optimize the Patient Experience: Collaborate with Key stakeholders to deliver value at every stage of the patient journey.

The Color of your Pill can Cause Non-Adherence

A US pilot study demonstrates that non-adherence to treatment can occur if the pill changes colour changes during treatment.



Switching from branded medication, to a different coloured generic counterpart during treatment can heavily influence a patient’s decision to continue with their medication, according to research from the Brighamand Women's Hospital and Harvard Medical School in Boston.

They discovered that patients will be as much as 50% more inclined to stop taking a drug if it's colour has changed since the last prescription.

Currently, generic medicines account for more than 70% of US prescriptions. This study, published online in JAMA Internal Medicine journal, compared compliance for brand and generic types of anti-epileptic drugs. It calculated the probability of patients not refilling their medication as a result of receiving pills that differed in colour and shape from previous prescriptions.       

Lead researcher in this study Aaron S. Kesselheim said: “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 behaviour. We found that changes in pill colour significantly increase the odds that patients will stop taking their drugs as prescribed.”

Of the 11,500 individuals who did not refill their medication, 1.2% were affected by their drugs changing colour. Around 0.97% of this figure got their prescriptions filled in on time. Although changes in pill colour do not occur frequently, researchers found that this alteration did make a difference between those who refilled their medication or not. In this study, 61,000 patients were taken one of eight drugs which were offered in 37 colours and four shapes. The shape of a pill rarely changes and findings of this study suggest that patient non-compliance is not linked to this kind of variation.

Associate editor of JAMA Internal Medicine Dr. Kenneth Covinsky, in a note complementing the study said: “If they [patients] are taking nine medicines, they get at least 36 'opportunities' a year to experience a colour change. This seemingly small risk then starts to appear very substantial. Equivalent generic medicines should be required to look like their brand-name counterparts.”

Kesselheim continued to say: “Patients should be aware that their pills may change colour 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. Finally, pharmacists should make a point to tell patients about the change in colour and shape when they change generic suppliers.”

However, at this stage, researchers cannot prove whether it was only the pill’s colour that stopped a patient from refilling their medication. This study’s value is limited unless further research is done in this area. Researchers should compare these findings with studies of other drugs while continually examining other factors that might affect non-adherence. Patients need to be informed that a pill’s appearance does not change the clinical value of the medication.   



Patients Centricity Canada

Jun 17, 2014 - Jun 18, 2014, Toronto

Optimize the Patient Experience: Collaborate with Key stakeholders to deliver value at every stage of the patient journey.