Visual Cues and Medication Compliance

Humans are interesting creatures. There are many things that we do unconsciously, or consciously for that matter, that are done in an effort to protect ourselves from an evolutionary perspective. Take for example Phobias. While they are ‘irrational fears’ they all steam from rational concerns of things which once had relevance to our survival as individuals and as a species such as dogs, heights, or patterns of holes.

Just as with phobia’s some of these rational decisions can actually put us at risk. For example, an interesting research study recently found that if individuals experience a change in color of their medications they will be less likely to comply with medications as prescribed by their doctor and refill their next prescription for that medication. The study looked at Medication Compliance in individuals with Epilepsy and found that:

“when patients with epilepsy refilled their prescriptions and received a different color pill than they were used to, they were  53% more likely to take a break from taking their drugs as prescribed.  Twenty-seven percent of patients taking antiepileptic drugs for other reasons also took a break from their prescribed drug regimen.  “Someone who knows it’s so important they take their medication to avoid a seizure is much more in tune with color… and (becomes) more stressed out with any potential switch,” says Kesselheim.”

This non-compliance, and nonpersistence as the researchers title it, might be the result of a type of unconscious, or conscious, self protection to avoid risks:

“Patients and caregivers frequently remove pills from their original bottles to organize them in daily pill planners.  “Visual cues thus become paramount to identification of pills,” says Kesselheim.  Therefore, changes in appearance may be jarring or confusing, leading patients to delay pill-taking while seeking validation from a physician, pharmacist, or other health care provider.”

But, this change could also influence the belief that a medication can work, an added reason not to comply and to protect oneself from unwanted medication use:

“Perhaps even more interesting, a pill’s physical attributes have been linked to expectations of efficacy of both placebos and prescription drugs.  Kesselheim says, “changes in appearance may not only deprive patients of these expectations of efficacy, but potentially even have the opposite effect.”  It’s something that’s called the “nocebo” effect, a belief that the newly-substituted pill will be less effective than the previous dose.”

With pharmacies switching medications for the cheaper generics without notice on a regular, and rising basis, this is cause for concern (especially when the majority of patients don’t take medications as prescribed to begin with). The researcher’s suggestion? Educate doctors to warn patients about changes in medication color, shape and size so that patients are prepared and their ‘survival instinct’ doesn’t kick in. Nip the ‘evolutionary’ urge to be concerned over changes in the butt before it becomes a medical issue.

Written By Georgianna Reilly, LMSW
SJS Staff Writer