"My doctor has changed my pills without telling me": impact of generic medication switches in stroke survivors

Julie A Chambers, Ronan E. O'Carroll, Martin Dennis, Cathie Sudlow, Marie Johnston

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7 Citations (Scopus)


Generic (i.e. non-branded medicine) and therapeutic (i.e. a less expensive drug from the same class) substitution of medication provides considerable financial savings, but may negatively impact on patients. We report secondary qualitative/quantitative analysis of stroke survivors from a pilot randomised controlled brief intervention to increase adherence to medication. Patients’ experiences of medication changes were examined in conjunction with electronically-recorded medication adherence. Twenty-eight patients reported frequent medication changes (e.g. size/shape/colour/packaging) and two-thirds of these reported negative effects, resulting in, at least, confusion and, at worst, mistakes in medication-taking. Patients reporting a direct effect on their medication-taking (n = 6) demonstrated poorer objectively-measured adherence (i.e. % doses taken on schedule) than those reporting confusion [mean difference = 19.9, 95 % CI (2.0, 37.8)] or no problems [mean difference = 20.6, 95 % CI (1.6, 40.0)]. Changes to medication resulting from switching between generic brands can be associated with notable problems, including poorer medication adherence, for a significant minority.
Original languageEnglish
Pages (from-to)890-901
Number of pages12
JournalJournal of Behavioral Medicine
Issue number5
Early online date14 Dec 2013
Publication statusPublished - Oct 2014



  • stroke
  • adherence
  • medication
  • generic substitution
  • therapeutic substitution

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