RT Journal
A1 Covinsky KE
T1 Debating effect sizes: Comment on “variations in pill appearance of antiepileptic drugs and the risk of nonadherence”
JF JAMA Internal Medicine
JO JAMA Internal Medicine
YR 2013
FD February 11
VO 173
IS 3
SP 209
OP 209
DO 10.1001/jamainternmed.2013.1545
UL http://dx.doi.org/10.1001/jamainternmed.2013.1545
AB 
However, others noted that over time, this seemingly small effect size could become quite important. Most patients refill a medicine at least 4 times a year. Over the course of several years, the risk of nonadherence owing to color change can add up even for 1 medicine. And consider the very common situation of an older patient dealing with a confusing regimen of many medicines. If they are taking 9 medicines, they get at least 36 “opportunities” a year to experience a color change. This seemingly small risk then starts to appear very substantial. Throw in some cognitive impairment and other sources of confusion, such as changing medication regimens each time a patient transitions in and out of the hospital, and it becomes easy to imagine how a medication color change can lead to a significant medication-related adverse event.