Effect of drug reminder packaging on medication adherence: a systematic review revealing research gaps

Abstract

BackgroundThis was a systematic review of the literature in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Evidence mapping was used to reveal the effect of drug reminder packaging on medication adherence, to identify research gaps and to make suggestions for future research.MethodsPubMed, Embase, CINAHL and PsycINFO were searched with an end date of September 2013 using the Medical Subject Headings (MeSH) term ‘medication adherence’ and 20 different search terms for ‘drug reminder packaging’, limited to the English and German languages. Additional references were identified through cross-referencing. All prospective controlled trials with an intervention using drug reminder packaging for patients taking at least one medication without the assistance of a health-care professional were included in the evidence mapping of the effect of drug reminder packaging on adherence and outcomes according to the Economic, Clinical and Humanistic Outcomes (ECHO) model.ResultsA total of 30 studies met the inclusion criteria: 10 randomized controlled trials, 19 controlled clinical trials and 1 cohort study. Drug reminder packaging had a significant effect on at least one adherence parameter in 17 studies (57%). The methodological quality was strong in five studies. Two studies provided complete information. Clear research gaps emerged.ConclusionsOverall, the studies showed a positive effect of drug reminder packaging on adherence and clinical outcomes. However, poor reporting and important gaps like missing humanistic and economic outcomes and neglected safety issues limit the drawing of firm conclusions. Suggestions are made for future research.

Study to Measure the impact of Pharmacists and Pharmacy Services (STOMPP) on Medication Non-Adherence: Medication Adherence and Clinical Outcomes

“…One possible reason for this is that blister packs provide a visual aid for patients who may struggle to remember to take their medications. [18][19][20] Additionally, they continued to see a gradual improvement in their proportion of days covered (PDC) scores, such that the average PDC score for this group was 0.90 at 12 months. Patients who were receiving MTM services saw improvements in their clinical outcomes in comparison to the patients in the pill bottle (PB) only group.…”

“…Dispensing medications in blister packaging rather than pill bottles has been shown to improve adherence and clinical outcomes. [18][19][20] This can replace pill boxes that patients or caregivers typically fill after receiving their prescriptions in pill bottles. 17 To reduce multiple trips to the pharmacy, pharmacies are able to synchronize patients' medications to be filled on one day.…”

A systematic review of patient medication error on self-administering medication at home

“…Foreseeably, there will be a marked increase in the number of very old people living alone, so that work on helping them to reduce the risks of home medication could become a priority in the area of patient safety. As occurs in the professional context, aids and tools that could be incorporated for reducing the likelihood of MEs constitute one of the core aspects in efforts to increase patient safety, and in this area the new technologies (we can cite two examples: e-prescriptions and medication-related apps) can contribute to greater security in the use of medicines, as already seems to be the case [102].…”

What is the place for monitored dosage systems?

“…A systematic review, published in 2014, identified 30 studies (5737 participants) on the use of drug reminder packaging 9. Ten were randomised controlled trials, 19 controlled clinical trials and one was a cohort study.…”