14.4 Manufacturers’ Innovations to Promote Safety

Drug manufacturers and retail packagers also have a role in improving medication safety in the ways they design and package their drug products. Many companies manufacture formulations and packaging with unique colors, shapes, or markings to assist in distinguishing between different types and dosages or competitor products. They are also including more patient educational materials. Technicians and pharmacists can take advantage of these safety innovations and offer them to their patients, especially to those who are vulnerable.

Some pharmaceutical manufacturers have the middle four numbers of the NDC or the middle letters of the drug name either in a larger font or boldface type to minimize selection errors. This can be helpful for patients and technicians with declining vision. Otherwise, without magnifying glasses, they could reach for the wrong medication. The ISMP has been recommending the use of “tall man lettering” warning statements on the stock labels of high-risk medications and other labeling changes to better differentiate products and dosages to reduce medication errors. “Tall man” is larger, bold lettering to distinguish similar medications, such as hydrOXYzine and hydrALAzine—two products that are available in similar doses. A list of other medications in the community and hospital pharmacy settings with “tall man” lettering is available at https://PharmPractice7e.ParadigmEducation.com/TallmanLetters.

Advances in technology—such as SMRxT’s Nomi pill bottles fitted with cellular technology that takes a weight reading every time the bottle is moved—are helping patients with medication adherence.

For other products, such as generic levothyroxine, different doses of the same medication have different colors printed on the front of the stock bottle. OTC drugs like Coricidin have varying colored packaging for the different formulations that address various indications. For some products, special markings on the tablet or capsule verify the drug and dose.

An innovation in packaging design for patients taking multiple medications comes from the mail-order PillPack Pharmacy. The PillPack provides an individualized packet of all medications that a patient needs to take at a given time. This makes taking drugs much easier and safer for elderly people. Medications are individually packaged in a time-of-day strip per each day that rolls out of a disposable dispenser (see Figure 14.3). The medications are also delivered to the patient’s home in all 50 states every two weeks, insurance is billed, and there is no additional cost.

Figure 14.3 PillPack Dispensing

PillPack provides an innovative packaging design to minimize patient medication errors.

Technology is being used to improve patient safety and medication adherence. AdhereTech’s Smart Pill Bottle system can send reminder text messages or phone calls for missed doses. The Smart Pill Bottle can also communicate with the dispensing pharmacy. SMRxT’s Nomi is a pill bottle that senses and records if and when a dose of a certain medication is taken. Missed dose reminders can be sent to the patient, as well as their families and caregivers.