Drugs that are identical inside and are equally effective may have different colors, shapes and sizes depending on the manufacturer but these seemingly trivial differences may actually influence the likelihood of patients taking them.

In a new study involving patients with cardiovascular disease who had heart attack, researchers observed that some patients would rather not take their medication if their medication does not have the same color or shape as the pill that they are used to take.

For the study published in the Annals of Internal Medicine on July 15, Aaron Kesselheim, from the Brigham and Women's Hospital, and colleagues wanted to find out if changing the color and shape of their pills could cause people to stop taking them so they tracked 11,513 patients with heart disease who were hospitalized between 2006 and 2011 due to heart attack and were prescribed medications after they were discharged.

Of the participants, 29 percent had pills that changed in shape and color during the duration of the study with statins having the most changes in appearance and beta blockers the least. While it is crucial that patients who had myocardial infarction take their medications as this could spell the difference between life and death, the researchers found that patients have the tendency to stop taking their medications if the appearance of the pills has changed.

They found that the patients whose color of pills were changed had 34 percent increased odds of stopping their medication compared to patients whose medications did not change in appearance. They also found that the patients whose shape of pills was changed had 66 percent increased odds of stopping their medications.

"Variation in the appearance of generic pills is associated with nonpersistent use of these essential drugs after MI among patients with cardiovascular disease," the researchers wrote.

Kesselheim and colleagues said that some of the patients may stop taking their medications when the appearance of the pill changes because they may get confused and become unsure whether or not they are taking the same drug. Some patients may also be uncomfortable with the changes when they are already used to taking a particular shape of the pill.

Nonetheless, the researchers said that stopping their medications could just worsen the condition of patients and this could lead to fatal consequences.

"After patients have a first heart attack, guidelines mandate treatment with an array of long-term medications and stopping these medications may ultimately increase morbidity and mortality," Kesselheim said.

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