This study measured the prevalence of difficulty experienced by elderly inpatients in opening and removing tablets from a range of common commercial medication packagings and in breaking a bar-scored tablet in half. One hundred and twenty elderly patients admitted to a teaching hospital acute geriatric service were tested for their ability to open the container and remove a tablet from it. They were rated as 'able' or 'unable' to do so. In all, 94 patients (78.3%) were unable to break a tablet or open one or more of the containers. Of the 111 patients taking medication at the time of their admission, 46 (41.4%) were unable to perform one or more tasks necessary to gain access to medications in their own treatment regimen. The factors that were significantly and independently associated with inability to open containers were poor vision, impaired general cognitive function, and female sex. Many of the drug packagings in common use significantly impede access by elderly patients to their medications.