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home / programmes / research associates / 2004 / richard and chris
Richard Mawle and Chris McGinley / Industrial Design Engineering
which pill when: medicine packaging that aids compliance in taking prescribed drugs
One consequence of a rapidly ageing population is the growing number of older people in society who must take prescribed medication on a strict regime of compliance. However, many older people find it difficult to take their pills or medicines to a regular timetable.
Older patients take three times as many drugs as the general population and their rates of non-compliance are higher - 55% compared to a 43% non-compliance rate for the general patient population. Overall, one in every two consumers of prescription-only medicines is said to be non-compliant.
The cost of this problem is enormous - estimated at £60 billion a year worldwide. In older patients, non-compliance accounts for 40% of all hospital admissions and contributes to 125,000 deaths a year. A quarter of nursing home admissions are due to an inability to take drugs as prescribed.
A stubborn problem
Plenty of different compliance aids exist to tell people which pill to take when. But according to Christopher Wood, innovation manager at pharmaceutical company GlaxoSmithKline, "This is a problem that refuses to go away. The question is how can we integrate the compliance aid into medication packaging in a way that is low-tech but of high value to the user?"
In the first year of the two-year project, existing compliance solutions were analysed and user behaviour was observed by handing out a specially-designed research diary to a group of patients taking prescribed drugs for such conditions as asthma, depression, diabetes, epilepsy and enlarged prostate.
A trio of design concepts were then generated to communicate three distinct problems related to non-compliance: accessing the pack, taking pills on the move, and remembering to take the medication. The resulting prototypes demonstrated how packaging could incorporate some form of low-cost compliance aid.
In the second year of the project, the study substantially expanded the user research base by consulting four distinct groups: people suffering from specific medical conditions such as asthma and arthritis; medication users with severe mobility impairments; a broader cross-generational group to gain insights into diverse needs; and a medical professional group of pharmacists, carers and nurses.
Each group assessed the initial prototypes and design iterations were introduced and refined in response to user feedback. Three proposals emerged from the study: the Access Pack, which has an easy-to-open matchbox-style mechanism and an access aid as an intrinsic part of the packaging; the Moving Pack, which has a special box detachable from the main pack to support discreet use of medication on the move; and the Remind Pack, which has a collection of prompts such as stickers and cards that can be removed from the pack and placed around the home as personal reminders.
Creative response
These three-dimensional pack exemplars form the centre-piece of a special Compliance Kit produced to provide design guidance on the issue for GlaxoSmithKline's in-house design teams. The kit, styled as a First Aid box, also includes simulation tools such as spectacles and gloves to better understand the reduced capabilities of older people, as well as visual prompts to highlight compliance issues and stimulate a more creative packaging approach.
research partner: GlaxoSmithKline