When the blister pack was conceived in the 1960s, it revolutionized unit-dose drug administration by providing a cheap, light, tamper-proof barrier that preserved product integrity. But it was also a fine example of packaging design that facilitated user compliance. Through assigning the days of the week to each pill on the blister packs, a simple container became a handy memory aid for regular pill takers—a critical mechanism for those on the contraceptive pill where one missed day could result in an unplanned pregnancy. Moreover, the design deterred mass pill consumption in a way that pill bottles did not, providing an additional barrier for safety.
But today, not much has changed. Some 12 million people older than 65 in the U.K. and 40 million in the U.S. take five pills per day to manage ailments, and their risk of overdosing or under-medicating is very real. Current packaging design, at the hands of the frail and near of sight, is not just impractical but potentially dangerous. And this danger doesn’t just relate to older individuals; it relates to the planet at large.
At the prime of health, we think nothing of popping a pill out of its blister. Sharp eyes and dexterous fingers make the simple act almost effortless. But what appears like second nature to the intermittent aspirin taker becomes a fiddly and frustrating task for those who are elderly and infirm struggling with shakes and arthritis. It is not democratically accessible.
Then there’s the sustainability issue. Blister packs comprise a multilayer of different materials: One to form a rigid structure, and the other to provide a pierceable membrane, making it a nightmare to recycle. Its very design requires the consumer to separate layers into mono-materials before they can be discarded into their respective recycling bins. If 12 million people in the U.K. are consuming, on average, five pills per day and the standard pill pack has around eight pills, that alone equates to approximately 2.7 billion pill packs tossed into landfills every year.
Pill bottles meanwhile present a different yet equally frustrating set of problems. Child- and tamper-resistant safety caps with a depress-and-twist-off mechanism are as much of a deterrent for older adults as they are for the children they are designed to protect. Security seals at the neck of the bottle that show the cap intact are tiny and removable only by considerable force. Then there’s the dispensing issue, with a design that works against the forces of gravity that practically invites the contents to spill everywhere.
Senior patients have for too long fallen prey to unempathetic design. What can be done about it?
The problem requires lateral thinking. Perhaps the solution lies not in a redesign of medication packaging itself but in creating altogether new ways for the drugs to reach the patient.
There has been some innovation in this space. PillPack, the online pharmacy acquired by Amazon in 2019 for $753 million, organizes medications into individual paper packets that are labeled with the date and time they should be taken and mailed to the patient. The dispenser box administers packs sequentially, making it clear if you’ve missed a day, while on the side of the box itself is an illustrated list of pills that allows you to cross-check that you’re taking the correct medication. However, fine print on the packets and on the box itself still leave the same challenges for people with visual and/or cognitive impairments. Inaccessibility has not been designed out.
And although the solution simplifies the management of complex drug plans, many issues have been raised around the compromising of product integrity in the name of convenience. A cursory glance of reviews shows that some patients have received incorrect medication or broken pills, highlighting how critically vulnerable the supply chain is to human error.
We might be able to forgive the odd erroneous or absent ingredient present in meal boxes we’re subscribed to and can still cook a meal with little consequence (give or take a slight variance in taste). But the same error in the dispensing of our prescription medications can have very grave consequences.
Hero is another innovative example of technology revolutionizing medication management. Its at-home pill dispensers organize medication and prompt patients to take the correct pills at the right time. But the system requires manual loading, leading us to the same cumbersome interaction with pill and blister packs.
A circular system for drug administration
These innovations are a step in the right direction but in order to be truly inclusive, not least to the burgeoning population of elders, it’s critical that these design flaws are ironed out. The design solution could be a fully integrated system in which pre-organized units of drugs, prepared according to prescription, are encased in containers that can be delivered to the home and loaded directly, like a cartridge in a printer, into a child-proof drug-dispensing machine designed inclusively with physically, visually, and cognitively impaired users in mind.
The organizing and compliance features of a Hero or a PillPack could be counterbalanced by a system that is structurally durable, preserves product integrity, is considerate of transportation and supply chain issues, and limits plastic use.
For example, a container molded from pressed medical-grade steel made compatible with an auto-dose appliance could feasibly store and dispense the correct medication at the right time while including safety features that do not rely on physical strength and dexterity to operate—rather, just adult-size hands. Structural design can be employed for simplified transportation, creating packs that are easily connectable, thus being economical on space. The containers themselves could be deconstructed with a specialist tool for cleaning, providing an additional barrier against tampering.
By looking holistically at the problem of accessibility and sustainability and redesigning its delivery and packaging infrastructure, the pharmaceutical industry will not only be able to manage costs better but also improve its user experience and lessen its considerable environmental footprint.
Tech innovation is not a panacea to a complex health and aging crisis. But human-centric, empathetic design can be optimized by technology to alleviate the user experience issues that degrade a senior adult’s quality of life.
It’s amazing to think how a seemingly innocuous blister pack can compound our everyday life and even endanger it when we’re at our most vulnerable. Interacting with it can feel like an everyday petty humiliation—an object that goads us and mocks our disability. But imagine a better alternative having a positive transformative effect on our experience, going even as far as giving back some quality and meaning to life when these two most important freedoms start to evade us in old age.
Can drug packaging really do all that?
If it can worsen, even threaten, our lives, then why can’t it improve them? We have the capability and resources to make that vision a reality—and it all begins from that empathetic, person-centered space. In the face of these looming social time bombs, that work must begin now.
Nick Dormon is managing director of brand design and innovation agency Echo.