A Survey of Patients' Perceptions of Pill Appearance and Responses to Changes in Appearance for Four Chronic Disease Medications.
BACKGROUND
Generic versions of a drug can vary in appearance, which can impact adherence.


OBJECTIVE
To assess the preferences, perceptions, and responses of patients who experienced a change in the appearance of a generic medication.


DESIGN
Cross-sectional survey of patients from a large commercial health plan.


PARTICIPANTS
Adults receiving generic versions of lisinopril, fluoxetine, lamotrigine, or simvastatin who experienced a change in the color or shape of their pills between March 2014 and November 2015.


MAIN MEASURES
Likert-scale responses to questions concerning perceptions of generic drug safety and effectiveness, reliance on and preferences for pill appearance, and responses to pill appearance changes. Multivariable logistic regression-modeled predictors of seeking advice and adjusting use following a pill appearance change.


KEY RESULTS
Of 814 respondents (response rate = 41%), 72% relied on pill appearance to ensure they took the correct medication. A similar percentage wanted their pills to remain the same color (72%), shape (71%), and size (75%) upon refill, but 58% would not have paid a $1 premium on a $5 co-pay to ensure such consistency. Most respondents (86%) wanted their pharmacists to notify them about pill appearance changes, but only 37% recalled such notification; 21% thought they received the wrong medication, and 8% adjusted medication use. Younger respondents (18-33 vs. 50-57 years) were more likely to seek advice (odds ratio [OR] = 1.91; 95% confidence interval [CI],1.02-3.59), and respondents with lower household income (< $30,000 vs. > $100,000) were more likely to adjust medication use (OR = 3.40; 95% CI,1.09-10.67).


CONCLUSIONS
Requiring uniform pill appearance may help increase adherence but presents challenges. Standardized pharmacy notification and education policies may be a more feasible short-term solution.
['Sarpatwari|Ameet|A|', 'Gagne|Joshua J|JJ|', 'Lu|Zhigang|Z|', 'Campbell|Eric G|EG|', 'Carman|Wendy J|WJ|', 'Enger|Cheryl L|CL|', 'Dutcher|Sarah K|SK|', 'Jiang|Wenlei|W|', 'Kesselheim|Aaron S|AS|']
D000293:Adolescent D000328:Adult D000368:Aged D002908:Chronic Disease D003430:Cross-Sectional Studies D016568:Drugs, Generic D005260:Female D006801:Humans D008297:Male D055118:Medication Adherence D008875:Middle Aged D057240:Patient Preference D010465:Perception D011795:Surveys and Questionnaires D055815:Young Adult
survey pill appearance chronic diseases medication adherence