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

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.