Non-adherence impairs the patients’ clinical condition as well as their quality of life and causes costs in the healthcare system. Dug reminder packaging (DremP), consisting of a compartments containing drugs for specific dosing times, like pillboxes or multidrug blister packs, are supposed to represent a simple method to help unintentionally non-adherent patients to better fulfil their treatment plan. In Switzerland, community pharmacies are used to prepare DremP for outpatients with chronic conditions. The multidrug blister pack Pharmis® is filled with oral solid medication, usually for one week (28 cavities for 4 dosing times a day).

An evaluation in 2011 showed that 51 community pharmacies in Switzerland provided Pharmis® blisters mainly to nursing homes (83%) and to 14% ambulant patients who were very old, suffered from dementia, or had external help with their medication. However, feedback from 22 of the ambulant patients was very positive. Pharmacists estimated the Pharmis® blister to enhance compliance by 66.1% ± 27.4% in ambulant patients who were initially non-compliant.

We suggest the circle of users for Pharmis® blister packs to be larger and that more younger patients or with complex therapeutic regimens, who are overstrained with the organisation of their drugs, or suddenly have to take many drugs (e.g. after hospital discharge) would take advantages from Pharmis® blisters.

Objectives
We will perform a randomised clinical trial with patients at discharge from the internal medicine’s ward of the University Hospital Basel.
The main question of interest is whether multidrug blister packs Pharmis®, equipped with POlymedication Electronic Monitoring System (POEMS), have an impact on the compliance of ambulatory patients resulting in improved clinical parameters, better quality of life, and reduced time to rehospitalisation in comparison to usual pharmaceutical care. A special focus will be on the usability and the acceptance of the device. Handling and patient satisfaction with Pharmis® blister will be compared to regular medication containers.