Medication compliance in elderly outpatients using twice-daily dosing and unit-of-use packaging

Abstract

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.