Focusing on the user – improving patient adherence through packaging design

MEDICATION non-adherence is one of the biggest obstacles for achieving effective healthcare, which can have potentially life-threatening consequences if patients misunderstand, forget or ignore healthcare advice. The most successful products are intuitive, easy to use and provide an enjoyable experience for the user. While there is no single intervention strategy that can directly improve adherence, there are several areas that pharmaceutical companies can focus their efforts on to ensure they connect with the end user and enhance compliance.

A focus on packaging

One area that can potentially affect adherence rates is product packaging, which is a key focus for Raymond Crosbie, Business Development Director at Design Partners. “Rather than creating packaging that is simply a protective medium for your product, you need to create a packaging experience for the patient,” he said. “If you think about instructions, we often see information folded in and around the drug containing a multitude of text with no discerning hierarchy in terms of what is important, which is not likely to engage the user to follow the instructions.”

Historically, pharmaceutical packaging designs have focused on quality assurance in a regulatorydriven process, with minimal inputs from the end user. “There was very little consideration of the people who use the medication,” said Crosbie, adding that this not only extends to the patient, but the prescribing physician, nurses, pharmacists and other healthcare providers involved in the distribution of medication. “Our thought is that if you create a packaging solution that is engaging, you can connect with all those people and form a ‘therapeutic alliance’ whereby positive interactions and discussions can be had from all parties.”

Cormac Ó Conaire, Creative Director at Design Partners, regularly designs pharmaceutical packaging and his key focus is the user experience. He described a “big shift” in pharma from volume‑based outcomes to an emphasis on value-based outcomes. “People are starting to put more focus on the end user,” he said. “When you reverse engineer your way of thinking, the question becomes very different: How can we capture the user’s attention? How can we enhance compliance? How can engagement drive adherence?”

When embarking on a design project, the first step he takes is to identify the challenge that needs resolving. “We know that we have a problem of adherence so we need to work out how we can make patients see the value of taking their drugs. Often it is seen as a chore, but there are so many simple solutions to help people perform rituals and build habits around their treatment. There are lots of technologies that can improve these rituals, helping patients build them into their daily lives.”

Crosbie explained that there are different methodologies that can be used to analyse the problem, depending on the situation. “This might be ethnographic research, contextual inquiry or voice of customer studies,” he said. For example, launching a product in different countries might require different patient strategies or presentation approaches, which is when user engagement is so important.

Processing for design

Following initial research, companies need to apply this behavioural science and analyse the information that is gathered, which is then fed into the product design. “If we can understand what the potential barriers to use are, then we can mitigate against them and de-risk the product,” explained Crosbie. “This process can be quite rigorous, but you are considering the human element. The documentation of this process will be included as part of the usability file to be submitted as part of the regulatory filing at a later date.”

Ó Conaire added that it is important to concentrate on the voice of the customer and leverage people’s senses to cultivate improved user participation. “Our ability to interact with the world is facilitated through our senses. We make complex decisions every day which are driven from deep within our sensory subconsciousness. If we can tap into these – and there are between 10 and 33 sensors depending on how you classify them – we can create a deeper engagement with people. Take beauty as an example; when humans experience anything beautiful, whether it is a painting, a piece of music or a piece of design, it triggers the reward centre in the brain and provides a kick of dopamine. Considering these subtle elements like packaging design can greatly improve the user journey.”

Once the initial research has been conducted, Ó Conaire suggests bringing the manufacturer into the conversation. “We like to build a story and so by bringing in the manufacturer early on in the process, we can work to achieve something together that we both believe in.” Furthermore, introducing the manufacturer during the early stages enables greater understanding of what the manufacturers are capable of, ensuring that the design is customised and the end product is of the highest quality. Crosbie added that it is wise to have the quality and regulatory teams involved at this point: “It can sometimes be hard to shift people’s minds away from the technical language and towards a user-centric design language, so I would suggest bringing them in as early as possible.”

Prototyping the design

In order to test a design quickly and effectively, Ó Conaire suggests creating a prototype as quickly as is feasible. “As soon as we come up with an idea, within 24 hours we will have multiple versions that we can test among ourselves, clients and then formally with users. This allows us to design at great speed and instead of describing a product on screen, we can visualise what it will look like.”

He explained that various levels of prototyping occur at different stages of the project: “In early stages, you are trying to validate your concepts and determine whether you are moving in the right direction. Then, as we progress, we are refining those prototypes and testing them to verify the design exceeds the users’ expectations.”

Ó Conaire added that every project is different and brings with it varying complexities. “You may be working with needles, syringes or swabs, where you are focusing on the component parts and where is best to put them. Other challenges arise if you have a refrigerated component or more complex medication kits. We also look at personalising the experience and have seen a trend towards providing information digitally to patients.”

Digitalising the experience

Technology provides the opportunity for companies to offer patients alternative ways to receive information relating to their medication and personalise their experience. However, this is often dependent on the demographic of the user. “We want to make it a personalised rather than generic experience by tailoring the user into the design experience,” explained Ó Conaire. “We have looked at different technologies, for example augmented reality. Using an app on their phone, a patient could see a replicate of the packaging of their product, but each important element would be numbered so they can interact with the information. However, we understand that a certain demographic of user would love this, while others would get confused by the technology.”

The opportunities to enhance patient experience are evidently vast and are increasingly being implemented to increase patient adherence to medication administration. Going forward, it is likely that technologies will develop further to facilitate a more patient-centred and personalised approach to packaging design.