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Could Changes in Pill Color and Shape Lead to Patient Adherence?

David W. Hodges
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Partner at Kennedy Hodges LLP practicing pharmacy error, medical malpractice and personal injury law
Posted on Feb 07, 2013

A recent study published online on December 31, 2012 in the Archives of Internal Medicine investigated differences in appearance, such as pill shape and color, among pharmaceutically equivalent drugs. The authors of this study asserted that the differences in appearance among bioequivalent drugs, both branded and generic drugs, could have severe consequences for patient care.

“Changes between generic products with different physical characteristics may cause confusion and result in reduced adherence or prescription error.” The findings of the study, authored by Aaron S. Kesselheim, MD, JD, MPH, from Brigham and Women’s Hospital and Harvard Medical School in Boston, Massachusetts, and colleagues, revealed that color and shape differences among similar drugs may lead to medication discontinuation.

The authors of this study reviewed medical and pharmacy data from Health-Core Integrated Research Database of 11,472 patients using antiepileptic drugs to find if there was a relationship between patient adherence to eight antiepileptic drugs and pill characteristics, such as shape and color.

According to the findings in the study, the authors did discover that changes in pill shape and color—more so color than shape—were linked to adherence among patients with seizure disorders. Because generic drugs are required to look different than their brand-name counterparts, patients who make the switch notice the change in pill color and shape and are more reluctant to continue taking the generic drug. The authors wrote that “[t]aking steps to permit (or even require) similarity in pill appearance among bioequivalent brand-name and generic drugs may offer another way to achieve better patient adherence to essential medication regimens.”

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