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Behavioral Economic Insights to Improve Medication Adherence in Adults with Chronic Conditions: A Scoping Review

Author

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  • Jacqueline Roseleur

    (The University of Adelaide)

  • Gillian Harvey

    (The University of Adelaide)

  • Nigel Stocks

    (Adelaide Medical School, The University of Adelaide)

  • Jonathan Karnon

    (The University of Adelaide
    Flinders University)

Abstract

Background and Objective Medication adherence is poor in patients with chronic conditions. Behavioral economic interventions may reduce biases that are associated with poor adherence. The objective of this review is to map the available evidence on behavioral economic interventions to improve medication adherence in adults with chronic conditions in high-income settings. Methods We conducted a scoping review and reported the study using the Joanna Briggs Institute Reviewers’ Manual and the PRISMA Extension for Scoping Review checklist. We searched PubMed, EMBASE, SCOPUS, PsycINFO, EconLit, and CINAHL from database inception to 29 August, 2018 for peer-reviewed studies and included a search of the gray literature. Data on study characteristics, study design, and study outcomes were extracted by one reviewer. Twenty-five percent of the studies were verified by a second reviewer. Results Thirty-four studies, targeting diabetes mellitus, human immunodeficiency virus, and cardiovascular and renal diseases met our inclusion criteria. All but two studies were from the USA. The majority of interventions used financial incentives, often in conjunction with other behavioral economic concepts. Non-financial interventions included framing, social influences, reinforcement, and feedback. The effectiveness of interventions was mixed. Conclusions Behavioral economic informed interventions show promise in terms of improving medication adherence. However, there is no single simple intervention. This review highlighted the importance of targeting non-adherent patients, understanding their reasons for non-adherence, providing reminders and feedback to patients and physicians, and measuring clinical outcomes in addition to medication adherence. Further research in settings that differ from the US health system is needed.

Suggested Citation

  • Jacqueline Roseleur & Gillian Harvey & Nigel Stocks & Jonathan Karnon, 2019. "Behavioral Economic Insights to Improve Medication Adherence in Adults with Chronic Conditions: A Scoping Review," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 12(6), pages 571-592, December.
    • Handle: RePEc:spr:patien:v:12:y:2019:i:6:d:10.1007_s40271-019-00377-8
    DOI: 10.1007/s40271-019-00377-8
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    References listed on IDEAS

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    1. Keith Kranker, "undated". "The Efficacy of Using Financial Incentives to Change Unhealthy Behaviors Among a Rural Chronically Ill and Uninsured Population," Mathematica Policy Research Reports 5d285b0236084a3989e4345e0, Mathematica Policy Research.
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