Exploring the factors associated with difficulties in extracting tablets or capsules from press-through-package sheets.

Exploring factors related to difficulties in extracting tablets or capsules from press-through-packages is essential for optimizing the dosage form. To achieve this, the involvement of patient insight is important. In the present study, the preferences of patients regarding drugs that are difficult to extract from their packaging were collected using an electronic medication notebook ('harmo®') based on dispensing data. We found that approximately 30% of respondents had difficulty removing tablets or capsules from their packaging, with 125 specific drugs identified as 'hard to push out'. Independent factors related to 'hard-to-push-out' drugs were female sex and feeling of weakness in the hands or fingers. Furthermore, several 'hard-to-push-out' drugs had characteristics such as a spherical shape or small major axis or small major axis drug-to-pocket size ratio. The findings of this study may help improve the quality of drug packaging, thus enhancing the patients' medication experience.