Kiyomi Sadamoto,1â 3 Mikio Murata,2,4 Masaho Hayashi,2,4 Hiroyuki Ura,1 Kiyoshi Kubota2,4 1Department of Clinical Pharmacy, Shonan University of Medical Science, Yokohama, Kanagawa, Japan; 2MECSION, General Incorporated Association, Hiratsuka, Kanagawa, Japan; 3Sadamoto Clinic, Ninomiya, Kanagawa, Japan; 4Department of Clinical Pharmacy Yokohama University of Pharmacy, Yokohama, Kanagawa, JapanCorrespondence: Kiyomi Sadamoto, Tel +81-45-921-0111Fax +81-45-821-0116Email kiyomi.sadamoto@gmail.comBackground: Blister packs with paperboard backing, which is useful for displaying instructions and information, are the most popular type of packaging for osteoporosis drugs in Japan. However, the main users of drugs are the aged, who often find blister packs difficult to open or drop their pills during opening. In this study, we compared different types of blister packs in terms of usability and handling.Methods: We conducted a subjective and objective study to compare commonly used blister packs with newly designed ones that have a jagged notch designed to hold a pill temporarily and a perforated line that enables the pack to be held easily in one hand. Regarding subjective data, packaging and sensory tests were performed. The participants in the sensory test were healthy older adults and patients with rheumatoid arthritis (RA). We also measured the pinch power of all participants.Results: A comparison of several items, including opening status, prevention of pill dropping, and understanding of the instructions, using a numerical rating scale revealed no significant differences between ordinary (type A) and newly designed (type B) packaging. However, the scores for type B were the same or better than those for type A for every evaluation item. In addition, more than 85% of the participants reported preferring to use type B. More than 80% of the participants in both groups reported dropping pills using type A, which seemed to be related to their preference for type B. In the evaluation by the examiner (objective study), all participants could successfully remove their pills without dropping using type B, including those in the RA group who had difficulty handling packages.Conclusion: These findings suggest that the new type of blister pack assessed in this study (type B) is preferable among older and shows promise for a universal design.Keywords: drug packaging, paperboard backing, older adults, new design, rheumatoid arthritis, universal design