​Work in the field of behavioral economics recently earned one of its leading theorists a Nobel Prize, but its use in healthcare is limited, according to a November 6, 2017, article in the New York Times. Behavioral economics looks at how psychological, social, cognitive, and emotional factors play into people's economic decisions. Experts have theorized that employing behavioral economic techniques could improve medication adherence, the article said; a 2014 Cochrane review found that the impact of medication adherence strategies overall is inconsistent. The Times article highlighted another study that “pulled out all the stops" in efforts to get patients to take their heart medication. Patients were given an electronic pill bottle and those who took their medicine had a 20% chance of winning $5 and a 1% chance of winning $50 every day for a year. The study also offered social support functions and access to healthcare system resources. The intervention failed to improve medication adherence or hospitalization rates. Behavioral economics may work better for public health issues, the Times article said, noting that such approaches have shown a modicum of success in helping people lose weight or quit smoking; however, even those successes may disappear if results are followed over a longer timeline. Ultimately, the article said, a major problem is that health has “many moving parts." Improving one aspect of care may be at the expense of another area of care. “Behavioral economics may offer us some fascinating theories to test in controlled trials," the article concludes, “but we have a long way to go before we can assume it's a cure for what ails Americans."

HRC Recommends: Healthcare providers and organizations can take steps to promote patient adherence to medication regimens. Health literacy and patient engagement strategies, such as "Ask Me 3" and "teach back," can support adherence. Providers should seek to establish an open, trusting relationship with patients and ask patients about their care goals, their thoughts about proposed tests and treatments, and barriers to and facilitators of medication adherence. Communication skills training can support providers in these efforts. Strategies to facilitate medication adherence include working with patients to prescribe medications, creating schedules in ways that meet patients' needs, supplying medications in blister packs of doses to be taken at the same time of day, and using reminder technologies.