ArticlePloS one2026
The need for patient-centric medicine design: investigating key physical characteristics of oral solid medications to improve acceptance of older patients in Addis Ababa, Ethiopia.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Patient-centric medicine design emphasizes developing medication products tailored to patients' specific needs and preferences, including size, shape, color, texture, packaging, and labeling. However, despite increasing recognition of patient-centered pharmaceutical design, evidence remains scarce on how medication and patient characteristics influence medication acceptance among older patients, particularly in low-resource settings such as Ethiopia. This study aimed to identify factors associated with the acceptance of oral solid medications among older adults. An institutional-based cross-sectional study was conducted from May to July 2024 in five public hospitals in Addis Ababa, Ethiopia. Data were collected through an interviewer-administered questionnaire capturing patient-related information (socio-demographics, clinical conditions, and medication beliefs) and medication-related characteristics (size, shape, score line, packaging, texture, dosage form, and labeling). Medication-level acceptance was measured using the MAQ-2019 tool. Descriptive statistics summarized the data, and bivariable and multivariable logistic regression analyses identified predictors of acceptance. Within-patient clustering was accounted for using cluster-robust standard errors. Among 408 older patients and 1,256 oral solid medications, 75% of medications were accepted. Medications sized 6-9 mm were more likely to be accepted (AOR = 6.50, 95% CI: 3.84-10.99, p < 0.001), while those ≥18 mm were less likely to be accepted (AOR = 0.15, 95% CI: 0.06-0.35, p < 0.001) compared with ≤6 mm. Medications with a score line were twice as likely to be accepted (AOR = 1.99, 95% CI: 1.32-3.00, p = 0.001). Older patients preferred small to medium-sized, coated, and scored tablets. Findings underscore the importance of age-appropriate formulation design and patient involvement in medication development.
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