The behavioral economics of drug adherence
For physicians, identifying the right drug to treat a patient may ultimately be just the first hurdle in recovery. Human behavior plays an important role in the way prescription drugs are evaluated, discussed and selected. Whether it’s taking medication or getting the Covid-19 vaccine, confirmation bias remains a hurdle to overcome when patients overestimate information that aligns their point of view and are unwilling to accept conflicting information.
“We’ll be much more effective at improving health-related behaviors if we work with the irrational parts of our nature… instead of ignoring or fighting them,” said David Asch, MD, MBA, executive director of Penn Medicine Center for Health Care. Innovation, according to the American Medical Association. “When it comes to healthcare, understanding our irrationality is just another tool in our toolbox. And exploit this irrationality, this movement perhaps the most rational of all. “
Thus, physicians can take a behavioral economics approach to understanding human behavior, as well as the biases and perceptions that become a factor for individuals when considering medical advice. This then gives doctors the ability to frame their interactions and influence their patients to make decisions that will have a positive impact on their health and to adhere to the medication.
Most suitable drug for a patient
Patients entering a doctor’s office with their diagnosis and their preferred medication to treat their disease are already a challenge for dynamic healthcare professionals. Once the diagnosis is made, the discussion of treatment progresses. As the doctor describes the prescription and explains to the patient the benefits and potential side effects associated with the drug, then its quality may be questioned. Is this the generic version? Are there any alternative medications or treatments? These are questions that arise frequently in a doctor’s office. “Communications often focus only on sharing information to fill a knowledge gap, when in fact the need is to fill a behavioral gap,” Asch said, according to an article on Val Health. If the patient is unfamiliar or hesitant with the drug, this provides the physician with the opportunity to better respond to the individual’s perceptions and inclinations about the drug and to establish a dialogue that will lead to a change in patient behavior. in their decision-making regarding the drug.
The financial implications of prescription drugs
Americans spend an average of $ 1,200 per person per year on prescription drugs. An individual’s socioeconomic status has the potential to affect their willingness to see a doctor and then take the prescribed medication. If a person does not have health insurance, the cost associated with out-of-pocket expenses is a major barrier to a visit to a doctor and can lead a person to avoid seeing their doctor. However, if an uninsured person has the resources to visit, the cost of filling a prescription may still not be achievable. Additionally, it was reported that 33% of patients intentionally failed to fill a prescription due to its high price tag. While an insured patient may request treatment, if they cannot afford it, treatment adherence decreases when their doctor is unaware of the cost of the drug and prescribes a drug that their patient does not. can’t afford to buy.
the medication adherence patient engagement
Doctors can prescribe and educate patients about medication, but patient adherence is required to follow recommended treatment. Doctors can use an adherence estimator to identify patients who may be at risk for medication nonadherence. If physicians determine that a patient may not meet their prescription, further communication may take place to influence a patient to remain committed to their treatment. While drugs help patients recover from illness, 75% of prescriptions are not taken as directed, so patients are not getting the full benefit. In addition, complications arise with prescription refills. With 25% of new prescriptions never filled and 40% of patients who fill their prescriptions not receiving a second refill after six months, it becomes a daunting task for physicians to get the patient back on track and get started. his recovery.
Colleen A. McHorney, internationally renowned thought leader in the areas of health outcomes assessment and medication adherence, and former senior scientist at Merck’s US Outcomes Research, told Pharmaceutical Executive magazine that “ I estimate from research by Merck and others that only 20% of non-adherence is due to oversights. The remaining 80% are made up of people making intentional decisions about their medications. You can text people whatever they want and sound the sirens on the caps of their pill bottles, but unless the patient feels like they need medicine and don’t have to worry about taking it, I don’t think the technology is going the forays that its advocates claim.
Reduce barriers to prescribing for patients
Doctors have barriers they face in diagnosing, prescribing and keeping their patient on treatment, such as a patient’s lack of accessibility to get a prescription from a pharmacy, fear of side effects, misinformation about the benefits of the drug or the cost of the drug. Physicians can have a positive impact on the lives of their patients by gaining a better understanding of their situation and learning how to best manage it with their patients. For example, sharing details about the availability of access to drugs through a patient assistance program to receive necessary medical care will give patients the opportunity to adhere to their medications, if financial circumstances are the obstacle to which a patient is faced to obtain a prescription.
“A key tenet of behavioral economics is not only to recognize that we are irrational, but that we are irrational in highly predictable ways. And to be effective, we need to know how to relate our programs to these predictable psychological weaknesses, ”Asch told AAMCNews.
In the United States, about 125,000 deaths per year are due to medication non-compliance, but by addressing these areas, physicians can better adapt to patient behaviors. As healthcare professionals take a behavioral economics route to understand patient actions, the more likely they are to identify the tactics needed to get patients to adhere to medicine. It is essential for physicians to consider the circumstances of their patient’s life while communicating the treatment plan and to engage them in a dialogue that addresses any challenges or hesitations they may have in achieving treatment adherence. .
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