'You need to be healthy to be sick': exploring older people's experiences with medication packaging at home

Abstract

Background: the ageing global population is living longer with complex health conditions addressed by multiple medications. Little is known about how older people manage these medications and associated packaging at home.

Objectives: to explore how older people manage the use of multiple medication and associated packaging in their process of self-care.

Methods: fifteen older, home-dwelling participants (mean age = 76.2 years) participated in this study. All participants used three or more daily medications and resided in Southern Sweden. Data were collected using photographs and written diaries completed by each participant over seven consecutive days, complemented by researcher-led interviews. Interviews and diary data were analysed using thematic analysis.

Results: six major themes emerged and are discussed: systematic organisation of medication, design of medication packaging, design of tablets, ease of package opening, emotional response to the need for medication, and environmental waste.

Conclusion: packaging plays an important role in protecting products and enabling easy storage, product longevity and transportation. Medication packaging is no exception. However, the design of medication packaging poses challenges for older people managing medications for their chronic health conditions at home. There is a need to facilitate the systematic management of multiple medications, especially for new medication regimes or changes in treatment. Design of both packaging and medication should be consistent for older users to avoid potential errors; difficulties opening packaging can potentially hinder adherence to treatment. This study highlights the need for patient-centred solutions and involvement of older people in a co-design process for medication and packaging design.

Keywords: Medication adherence; medication packaging; older people; packaging design; qualitative research; solicited diaries.

Figure 1

Use of cues. Diary notes: Top left: ‘I always remember the medications I should take in the evening when I prepare to brush my teeth’ (P11). Top right: ‘Weekly dosette filled and serving glass which I fill afterwards’ (P14). Bottom left: ‘A medication I take together with another one. It tastes bad, so I take it with juice.’ (P5). Bottom right: ‘It [the picture] shows how I dose my medications daily’ (P2).

Figure 2

Cues on medication use. Diary notes: Left: ‘It is an exemplary list of important tasks about the content and handling. Easy to find, easy to read and to grasp. This should be a standard for all types of medications’ (P2). Centre: ‘How much a person reads, comprehends, continuity, credibility, necessity, identification etc. Is that too much information in the current accelerated information flow? How to follow that up?’ (P1). Right: ‘Such a long description. Just to open the lid you need 1, 2, 3, 4 pictures plus text. I think it’s bad’ (P5).

Figure 3

Examples of tools used to open the packaging.

Figure 4

Packaging waste photographed by participants. Diary notes: Left: ‘Lots of rubbish! Many medications that you do not know how to sort the waste. I think medication packaging should tell how they should be sorted’ (P9). Centre: ‘Pile of rubbish after I have sorted my medications into the dosette’ (P10). Right: ‘My medication packaging in plastics. The plastic bottles are filled just to 1/3, so unnecessary!’ (P6).