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Medication compliance in elderly outpatients using twice-daily dosing and unit-of-use packaging
M D Murray1, J A Birt, A K Manatunga
1Department of Pharmacy Practice, School of Pharmacy, Purdue University, Wishard Memorial Hospital, Indianapolis, IN 46202.
Objective:
To determine the effect of unit-of-use drug packaging of medications on compliance among elderly outpatients treated with complex medication regimens.
Design:
Nonblind, randomized, clinical trial.
Setting:
Geriatric outreach health centers in urban public housing units for independent-living elderly people.
Patients:
Thirty-one patients (aged > or = 60 y), each taking three or more prescribed medications. Patients were randomly assigned to one of three study groups: group 1 (n = 12), no change in dosing or packaging; group 2 (n = 10), conventional packaging with twice-daily dosing; group 3 (n = 9), unit-of-use packaging with twice-daily dosing.
Intervention:
A unit-of-use package consisting of a two-ounce plastic cup with a snap-on lid containing all medications to be taken at the time of dosing.
Main Outcome Measures:
Medication compliance was assessed monthly for six months using tablet counts.
Results:
Medication compliance was significantly better in group 3 (92.6 percent) using unit-of-use packaging compared with either group 1 (79 percent) or group 2 (82.6 percent) (p = 0.017). Compliance did not differ between groups 1 and 2.
Conclusions:
In this small study of elderly outpatients taking three or more medications, unit-of-use packaging and twice-daily dosing improved medication compliance compared with conventional packaging.