Could Pill Color Matter?

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Clothes, cars, curtains, and cell phones.

Each of these has something in common: people care about their color. Car customers may wait weeks for that new hybrid in their favorite color. They may love the design of the shirt in the store—and it’s on sale—but walk away because that color just doesn’t fit their wardrobe. The curtains have to match the rug and sofa, and that cell phone case has to make it stand out, lest it goes lost.

But what about medication from the local pharmacy? Unlike that choice in cars or a dress, it’s not possible to say, “Yes, I’d like the antibiotic in a dark green,” or, “This month I’d like my high blood pressure medication in a light purple please.”

Imagine if that option were available…and if it influenced whether you actually took the medication as prescribed.

I get excited when I encounter a brilliantly simple idea, and this is a perfect example. Rema Amawi, Assistant Professor in the Department of Sciences and Liberal Arts at the Rochester Institute of Technology of Dubai, explored this question as the lead author in a recent study (Amawi & Murdoch, 2022). The researchers wondered if people relate the color of pills to how effective they think the medication will be.

Amawi explained to me that her research idea came from an episode with a flu-ridden son who would only take the “orange tiger,” his nickname for a liquid syrup painkiller. If the medicine were another color, such as blue or yellow, he wouldn’t have had the slightest interest in taking it. Orange also related to tigers in his mind, a connotation that heightened his willingness to drink the syrup. If color mattered to him, she reasoned, would it also be a variable in others’ decisions about medication use?

In a series of surveys in four countries, Amawi and Murdoch asked participants to complete a color identification test before asking them about their perceived efficacy of the medications. The study included sedatives, stimulants, anti-anxiety, pain relief, antacids, and hallucinogenics using the colors blue, green, white, red, and yellow.

In considering stimulants, participants ranked red highest for expected efficacy, while blue and white were rated highest for anti-anxiety medications. Yellow and red ranked highly for hallucinogenic medication. Incidentally, the color of pills was found to be significant for residents of the U.S.A. and the United Arab Emirates, but not for the two other countries, Croatia and Kosovo.

In an experiment from the same study, Amawi and Murdoch asked participants about the reason for choosing the color related to perceived efficacy. Eight possible reasons were offered to participants, including previous knowledge about similar medications and reminders of a memory or connection to something similar found in nature or landscapes.

Across all types of medications, participants selected reasons related to an emotional link, something symbolic to them personally, or a known medication of that type. Interestingly, advertising seemed to have no effect on participants’ color choices.

“It would be natural to assume that ads would influence patients’ color preferences,” Dr. Amawi said. “Perhaps, however, there is something else at play.”

The implications of this creative topic may have deeper implications. Perceptions of pill color may relate to patient expectancy effects. Maybe they also link to patient adherence? As Straub (2019) noted, several types of non-adherence exist, and the related financial costs are substantial.

One of Straub’s recommendations for enhancing adherence is to tailor treatment to a patient’s lifestyle. Perhaps a part of that lifestyle could include perceptions about taking a medication and, specifically, choosing a pill color that may increase the chances of using it as recommended in the treatment regimen.

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In a solution-focused approach, small steps lead to larger steps: Inches in progress may prompt gains measured in feet and yards in moving toward the goal. Amawi and Murdoch’s (2022) work may lead to other ideas for enhancing medical adherence in some small ways…even as small as a pill.