Adherence Packaging

Adherence packaging includes a range of tools designed to make medication-taking easier, safer, and more consistent. These solutions help patients stay organized, reduce medication errors, and improve day-to-day adherence—especially when combined with pharmacist support. Packaging options span from simple pill organizers to pharmacy-filled blister packs and advanced smart-packaging technologies.

Pill Organizers

Pill organizers are divided into compartments labelled by day (and sometimes time of day). They help patients visualize what they have taken and what remains for the day, reducing missed or duplicate doses.

However:

Patients or caregivers must fill these organizers themselves.

This requires adequate health literacy, physical dexterity, vision, and memory.

There is no pharmacist verification of accuracy.

Errors during sorting are common, especially for patients on multiple medications or with cognitive limitations.

Pill organizers can support routine but offer **no safety check** and rely fully on the patient’s ability to fill and manage them correctly.

Unit-Dose & Multi-Dose Blister Packs

Blister packs—also known as compliance packaging, bubble cards, or medication cards—are pharmacy-prepared packs designed to simplify medication management. They come in two main formats:

Unit-Dose Blister Packs

One medication per cavity

Typically organized for 28–31 days

Ideal for medications that cannot be mixed with others

Each cavity is labelled with day/date for tracking

Multi-Dose Blister Packs

Multiple medications grouped in the same cavity

Organized by time of day: morning, noon, evening, bedtime

Available in:

Weekly, four-times-per-day formats
Monthly, once-per-day formats

Simplify complex regimens by showing exactly what to take and when

Why Blister Packs Improve Adherence

Blister packaging:

Reduces confusion, missed doses, and timing errors

Can be synchronized so all prescriptions are ready at the same time

Removes the need for patients to sort their medications

Provides pharmacist-verified accuracy and quality control

Helps patients visually track dosing

Studies show blister packaging improves adherence measurements such as **MPR** and reduces dosing errors, particularly for older adults and those with cognitive challenges [14,15].

Electronic Medication Monitors

Electronic medication monitors track when a medication bottle or device has been opened, dispensed, or activated. They provide:

Digital timestamps of dose events

Data for pharmacists, providers, or caregivers to assess adherence [1]

Alerts or reminders (depending on device type)

A low-tech entry point into digital adherence monitoring

These devices support refill-level adherence insights but do **not** verify ingestion.

Smart Electronic Adherence Packaging

Smart blister packaging integrates printed electronics that detect when a specific cavity has been opened. These systems can:

Send reminders to the patient when a dose is missed

Notify caregivers or clinicians in real time when a compartment is opened on schedule

Provide peace of mind for families and care networks

Offer dose-by-dose adherence data (far more granular than refill data)

This form of packaging has been shown to be acceptable and easy to use for older adults managing complex regimens and can significantly enhance support for community-dwelling seniors [16].