Nudging Healthy Survivors to Take Their Meds

A NYTimes article addresses an issue essential to Healthy Survivorship: Taking prescriptions properly.

One would think a heart attack would be a powerful motivator to taking proper action from then on. Studies indicate adherence to medications is notoriously low in that setting. 

In Don't Nudge Me: The Limits of Behavioral Economics in Medicine, Dr. Aaron Carroll,  a professor of pediatrics, presents the conclusion of a study looking at the impact of electronic reminders, financial Incentives, and social support on patient outcomes after heart attacks. The HeartStrong Randomized Clinical Trial showed "...wireless pill bottles, lottery-based incentives, and social support did not significantly improve medication adherence." Readmission rates for circulation problems remained the same, too. 

Dr. Carroll blamed the problem on health having so many moving parts and the health care system even more--a conclusion that troubles me. I'd argue the interventions take away patients' sense of ownership of their health path.

Maybe we'd do better if physicians explored with their patients...

  • All the possible reasons, big and small, why patients are not taking their medications 
  • Patients' beliefs about the power of medications to improve their health
  • Patients' beliefs about the consequences of not adhering 
  • Patients' hopes for their health

I'd like to see a study that explored the impact of encouraging Healthy Survivorship. Here, clinicians would learn about and address the specific obstacles to compliance, commit to working together to personalize the medication regimen, and nourish patients' hope that compliance makes a difference. 

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