Press-Through Packaging versus Bold and Slim Bottle-Type Containers: A Comparative Evaluation of Drug Packaging Usability in Patients with Rheumatic Diseases.

Background: Improved drug adherence and usability over the long term are urgent issues in Japan. Press-through packaging (PTP) is commonly used for prescription and over-the-counter drugs; however, some patients, particularly those with finger deformities or weak functional pinch strength in their hands, have difficulty opening and removing pills from PTP. The present study aimed to investigate whether alternative ways to distribute drugs could be a practical solution for such individuals. Methods: We prepared three types of drug packages/containers, including PTP and "Bold" and "Slim" bottle types, and then conducted evaluations of their usability and preferences among 26 outpatients (22 women, 4 men; mean age: 72.6 years). We also measured the functional pinch and grip strength of the participants and investigated the related usability and preferences. Results: Some patients could not open PTP. On the other hand, every patient, even those with no prior experience, could easily use the Bold and Slim bottle-type containers. The release times (ie, the time it takes to dispense two pills from a container) for PTP and Slim were almost the same. Regarding Bold, the difference between the minimum and maximum release times was the smallest among all three types (Bold mean extraction time = 5.4 ± 2.2 s, p < 0.05). Even among the participants who were able to remove the pills from all three types of packages/containers without any difficulties, Bold required the least amount of time. Regarding the relationship between pinch strength and usability, Bold had a positive correlation with the key pinch position and was preferred by the participants. Conclusion: In the present study, Bold showed faster extraction times and slightly higher preference scores, although these differences were not statistically significant. Although the sample size was small, the participants preferred the Bold bottle-type container, which they found easy to use. These findings suggest that individuals with impaired hand and finger function prefer Bold bottle-type containers as drug packaging. Thus, the use of such packaging could help improve drug adherence and usability for some users over the long term.