Beyond Pharmacology: Do Tablet Shape, Size, and Color Influence Medication Adherence in Psychiatric Outpatients?

Q4 Medicine

The primary care companion for CNS disorders Pub Date : 2026-06-30 DOI:10.4088/PCC.25m04101

Rajat Rawat, Pravesh Thapliyal, Raunak Kumar, Yogesh Joshi, Shobit Garg

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引用次数: 0

Abstract

Background: Medication nonadherence is a multifaceted challenge in psychiatric treatment, driven by clinical, psychosocial, and patient factors. An understudied aspect is the physical properties of solid oral dosage forms (SODFs)-shape, size, and color-which may influence acceptability and adherence. Yet, quantitative evidence connecting real-world preferences to adherence outcomes is scarce, especially in psychiatric settings.

Objective: To evaluate preferences for tablet shape, size, and color among psychiatric outpatients and their relation to self-reported adherence.

Methods: This cross-sectional observational study, conducted over 6 months (April-October 2024) in a tertiary psychiatric unit, included 232 patients with varied psychiatric diagnoses on oral medications. Sociodemographics, clinical details, and preferences/dislikes for tablet attributes (shape: flat circular vs oval/oblong; size: small, medium, large; color: white, yellow, red, blue) were gathered via a structured questionnaire. Adherence was measured using the validated 10-item Medication Adherence Rating Scale (score ≥6=adherent). Associations were analyzed with χ² and Fisher exact tests (P<.05).

Results: The cohort (mean age: 36±13.3 years; 65.1% male) had 74.1% adherence (95% CI, 68.1-79.3%). Preferences included oval/oblong shapes (43.5%), small sizes (41.4%), and white colors (41.8%); dislikes were large sizes (53.4%), flat-circular shapes (40.5%), and red colors (33.6%). No significant links existed between preferences/dislikes and adherence (all P >.05; χ² = 1.90-4.64; Cramér's V=0.09-0.14). Adherence rates varied by diagnosis (lowest in psychosis: 30.8%; 95% CI, 12.7-57.6% and highest in generalized anxiety disorder: 85.0%; 95% CI, 64.0-94.8%) but nonsignificantly (χ² =16.70, P= .081, Cramér's V=0.27).

Conclusion: Psychiatric patients show distinct esthetic preferences for tablets, consistent with prior acceptability research, but these do not predict adherence. Clinical symptoms, illness insight, and therapeutic alliance appear to dominate. Strategies should emphasize psychosocial interventions rather than formulation esthetics.

Prim Care Companion CNS Disord 2026;28(4):25m04101.

Author affiliations are listed at the end of this article.

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超越药理学：药片的形状、大小和颜色是否影响精神科门诊患者的药物依从性？

背景：在精神科治疗中，药物不依从是一个多方面的挑战，由临床、社会心理和患者因素驱动。一个未被充分研究的方面是固体口服剂型（SODFs）的物理性质——形状、大小和颜色——这可能会影响可接受性和依从性。然而，将现实世界偏好与依从性结果联系起来的定量证据很少，特别是在精神病学设置中。目的：评价精神科门诊患者对片剂形状、大小和颜色的偏好及其与自我报告依从性的关系。方法：这项横断面观察性研究，在三级精神科进行了6个月（2024年4月至10月），包括232名口服药物的不同精神诊断患者。通过结构化问卷收集了社会人口统计学、临床细节和对片剂属性的偏好/不喜欢（形状：扁平圆形vs椭圆形/长方形；尺寸：小、中、大；颜色：白色、黄色、红色、蓝色）。依从性采用经验证的10项药物依从性评定量表（评分≥6=依从）进行测量。采用χ2和Fisher精确检验分析相关性(结果：该队列（平均年龄：36±13.3岁，男性占65.1%）的依从性为74.1% （95% CI, 68.1-79.3%）。偏好包括椭圆形/长方形（43.5%）、小尺寸（41.4%）和白色（41.8%）；不喜欢的是大尺寸（53.4%）、平面圆形（40.5%）和红色（33.6%）。喜好/不喜欢与依从性之间不存在显著联系（P均为0.05;χ2 = 1.90-4.64; cramsamr’s V=0.09-0.14）。依从率因诊断而异（精神病最低：30.8%;95% CI, 12.7-57.6%；广泛性焦虑障碍最高：85.0%;95% CI, 64.0-94.8%），但无显著性差异（χ2 =16.70， P= 0.081, cram氏V=0.27）。结论：精神病患者对片剂表现出明显的审美偏好，与先前的可接受性研究一致，但这些并不能预测依从性。临床症状、疾病洞察力和治疗联盟似乎占主导地位。战略应强调心理社会干预，而不是公式美学。Prim Care Companion CNS disorders; 2026;28(4):25m04101。本文末尾列出了作者所属单位。

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来源期刊

The primary care companion for CNS disorders Medicine-Medicine (all)

CiteScore

1.50

自引率

0.00%

发文量

300

期刊介绍： Founded in 1998, The Primary Care Companion for CNS Disorders (ISSN 2155-7780), formerly The Primary Care Companion to The Journal of Clinical Psychiatry, is an international, peer-reviewed, online-only journal, and its articles are indexed by the National Library of Medicine. PCC seeks to advance the clinical expertise of primary care physicians and other health care professionals who treat patients with mental and neurologic illnesses. PCC publishes research from disciplines such as medicine, nursing, pharmacy, and psychology, especially as it pertains to integrated delivery systems and interdisciplinary collaboration. PCC focuses on providing information of direct clinical utility and giving a voice to clinician researchers. Practice-based research from individuals and groups with clinical expertise is particularly welcome. Pertinent manuscript types include: -Original research -Systematic reviews -Meta-analyses -Case reports and series -Commenting letters to the editor Articles published in PCC typically cover attention-deficit/hyperactivity disorder, depression, bipolar disorder, anxiety, addiction, sleep disorders, pain, Alzheimer’s disease, multiple sclerosis, and Parkinson’s disease.