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

2019 ◽  
Vol 12 (6) ◽  
pp. 571-592 ◽  
Author(s):  
Jacqueline Roseleur ◽  
Gillian Harvey ◽  
Nigel Stocks ◽  
Jonathan Karnon
Keyword(s):  
Medication Adherence ◽  
Scoping Review ◽  
Chronic Conditions ◽  
Improve Medication Adherence ◽  
Behavioral Economic

The use of gamification and incentives in mobile health apps to improve medication adherence: a systematic scoping review (Preprint)

2021 ◽  
Author(s):  
Steven Tran ◽  
Lorraine Smith ◽  
Sarira El-Den ◽  
Stephen Carter
Keyword(s):  
Medication Adherence ◽  
Scoping Review ◽  
Computer Games ◽  
Financial Incentives ◽  
Mobile Apps ◽  
Evidence Synthesis ◽  
Significant Heterogeneity ◽  
Improve Medication Adherence ◽  
Screening Process ◽  
Published Evidence

BACKGROUND Emerging healthcare strategies to address medication adherence include the use of direct-to-patient incentives or elements adapted from computer games. However, there is currently no published evidence synthesis on the use of gamification and/or financial incentives in mobile applications (apps) to improve medication adherence. OBJECTIVE To explore the use of gamification and/or financial incentives in mobile apps to improve medication adherence. METHODS The following databases were searched for relevant articles published in English up to 24th of September: Embase, MEDLINE, PsycINFO, CINAHL and Web of Science. Arksey and O’Malley’s framework and the PRISMA-ScR checklist guided this systematic scoping review. Using a systematic screening process, studies were included if incentives and/or game features were used in mobile apps to address medication adherence. RESULTS An initial 691 potentially relevant articles were retrieved. Using a systematic process, 11 studies were included in this review. Across the studies, gamification alone (n=9) was used more than financial incentives (n=1) alone or a combination of the two (n=1). There was great variability in the development of the apps and underpinning theories. Patient involvement and contributions were not commonly seen in predevelopment but were evident in evaluations of feasibility, acceptance and effectiveness. The studies generally reported improved or sustained optimal medication adherence outcomes with gamification and financial incentives; however, there were significant heterogeneity in the patient population, methodology such as outcome measures and reporting of these studies. CONCLUSIONS To address medication adherence via gamified and incentivised mobile apps, an evidence-based co-design approach and agile methodology should be used during development. Further research in a generalised cohort of patients living with chronic conditions would facilitate the identification of barriers and potential opportunities for the use of gamification and financial incentives in mobile apps for medication adherence.

scholarly journals Barriers, facilitators, and interventions for medication adherence across chronic conditions with the highest non-adherence rates: a scoping review with recommendations for intervention development

2020 ◽  
Author(s):  
Pinelopi Konstantinou ◽  
Angelos P Kassianos ◽  
Giοrgos Georgiou ◽  
Andreas Panayides ◽  
Alexia Papageorgiou ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Behavioral Health ◽  
Scoping Review ◽  
Low Income ◽  
Chronic Conditions ◽  
Health Interventions ◽  
Barriers And Facilitators ◽  
World Health ◽  
Medication Cost ◽  
Multicomponent Interventions

Abstract Medication non-adherence (MNA) constitutes a complex health problem contributing to increased economic burden and poor health outcomes. The Medication Adherence Model (MAM) supports that numerous processes are involved in medication adherence (MA). Based on the MAM and guidelines of the World Health Organization (WHO), this scoping review aimed to identify the barriers and facilitators associated with MA, and the behavioral health interventions and techniques among chronic conditions presenting with high non-adherence rates (asthma, cancer, diabetes, epilepsy, HIV/AIDS, and hypertension). PubMed, PsycINFO, and Scopus databases were screened, and 243 studies were included. A mixed methods approach was used to collate the evidence and interpret findings. The most commonly reported barriers to MA across conditions were younger age, low education, low income, high medication cost, side effects, patient beliefs/perceptions, comorbidities, and poor patient–provider communication. Additionally, digitally delivered interventions including components such as medication and condition education, motivational interviewing (MI), and reinforcement and motivational messages led to improvements in MA. This review highlights the importance of administrating multicomponent interventions digitally and personalized to the patients’ individual needs and characteristics, responding to the adherence barriers faced. This is the first review examining and synthesizing evidence on barriers and facilitators to MA and behavioral health interventions used for improving MA across chronic conditions with the highest non-adherence rates and providing recommendations to researchers and clinicians. Stakeholders are called to explore methods overcoming barriers identified and developing effective multicomponent interventions that can reduce the high rates of MNA.

scholarly journals Effectiveness of mailed letters to improve medication adherence among Medicare Advantage Plan participants with chronic conditions

2018 ◽  
Vol Volume 13 ◽  
pp. 37-46 ◽  
Author(s):  
Amanda Mann ◽  
Tara W. Esse ◽  
Omar Serna ◽  
Liana D. Castel ◽  
Susan M. Abughosh
Keyword(s):  
Medication Adherence ◽  
Chronic Conditions ◽  
Medicare Advantage ◽  
Improve Medication Adherence

scholarly journals Improving medication adherence among kidney transplant recipients: Findings from other industries, patient engagement, and behavioral economics—A scoping review

2016 ◽  
Vol 4 ◽  
pp. 205031211562502 ◽  
Author(s):  
Shelley R Oberlin ◽  
Stephen T Parente ◽  
Timothy L Pruett
Keyword(s):  
Medication Adherence ◽  
Kidney Transplant ◽  
Scoping Review ◽  
Patient Engagement ◽  
Collaborative Partnerships ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Improve Medication Adherence ◽  
Increased Risk ◽  
The Right

The immune system is a powerful barrier to successful organ transplantation, but one that has been routinely thwarted through modern pharmacotherapeutics. Despite the benefits of immunosuppressive therapy, medication non-adherence leads to an increased risk of graft rejection, higher hospital utilization and costs, and poor outcomes. We conduct a scoping review following Arksey and O’Malley’s five-stage framework methodology to identify established or novel interventions that could be applied to kidney transplant recipients to improve medication adherence. As the desired outcome is a behavior (taking a pill), we assess three areas: behavioral-focused interventions in other industries, patient engagement theories, and behavioral economic principles. Search strategies included mining business, social sciences, and medical literature with additional guidance from six consultative interviews. Our review suggests that no intervention stands out as superior or likely to be more effective than any other intervention; yet promising strategies and interventions were identified across all three areas examined. Based on our findings, we believe there are five strategies that transplant centers and other organizations can implement to improve medication adherence: (1) Build a foundation of trust; (2) Employ multiple interventions; (3) Stratify the population; (4) Develop collaborative partnerships; and (5) Embed medication adherence into the organization’s culture. The effectiveness of these interventions will need to be investigated further, but we believe they are a step in the right direction for organizations to consider in their efforts to improve medication adherence.

A Scoping Review of Methods Used to Assess Medication Adherence in Patients with Chronic Conditions

2021 ◽  
Author(s):  
Pinelopi Konstantinou ◽  
Orestis Kasinopoulos ◽  
Christiana Karashiali ◽  
Geοrgios Georgiou ◽  
Andreas Panayides ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Quality Indicators ◽  
Scoping Review ◽  
Chronic Conditions ◽  
Electronic Monitoring ◽  
Intervention Development ◽  
Assessment Methods ◽  
Self Report ◽  
Evidence Based ◽  
Gold Standard Method

Abstract Background Medication nonadherence of patients with chronic conditions is a complex phenomenon contributing to increased economic burden and decreased quality of life. Intervention development relies on accurately assessing adherence but no “gold standard” method currently exists. Purpose The present scoping review aimed to: (a) review and describe current methods of assessing medication adherence (MA) in patients with chronic conditions with the highest nonadherence rates (asthma, cancer, diabetes, epilepsy, HIV/AIDS, hypertension), (b) outline and compare the evidence on the quality indicators between assessment methods (e.g., sensitivity), and (c) provide evidence-based recommendations. Methods PubMed, PsycINFO and Scopus databases were screened, resulting in 62,592 studies of which 71 met criteria and were included. Results Twenty-seven self-report and 10 nonself-report measures were identified. The Medication Adherence Report Scale (MARS-5) was found to be the most accurate self-report, whereas electronic monitoring devices such as Medication Event Monitoring System (MEMS) corresponded to the most accurate nonself-report. Higher MA rates were reported when assessed using self-reports compared to nonself-reports, except from pill counts. Conclusions Professionals are advised to use a combination of self-report (like MARS-5) and nonself-report measures (like MEMS) as these were found to be the most accurate and reliable measures. This is the first review examining self and nonself-report methods for MA, across chronic conditions with the highest nonadherence rates and provides evidence-based recommendations. It highlights that MA assessment methods are understudied in certain conditions, like epilepsy. Before selecting a MA measure, professionals are advised to inspect its quality indicators. Feasibility of measures should be explored in future studies as there is presently a lack of evidence.

scholarly journals Factors Contributing to Medication Adherence in Patients with a Chronic Condition: A Scoping Review of Qualitative Research

Pharmaceutics ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1100
Author(s):  
Kirsi Kvarnström ◽  
Aleksi Westerholm ◽  
Marja Airaksinen ◽  
Helena Liira
Keyword(s):  
Medication Adherence ◽  
Scoping Review ◽  
Qualitative Studies ◽  
Cochrane Library ◽  
Patient Specific ◽  
Improve Medication Adherence ◽  
Related Factors ◽  
Effective Interventions ◽  
Study Results ◽  
Specific Medication

Introduction: Medication adherence continues to be a significant challenge in healthcare, and there is a shortage of effective interventions in this area. This scoping review studied the patient-related factors of medication adherence. Methods: We searched Medline Ovid, Scopus, and Cochrane Library from January 2009 to June 2021 to find the most recent original qualitative studies or systematic reviews that addressed the patient-related factors of medication adherence in treating chronic conditions. We used the PRISMA-ScR checklist to ensure the quality of the study. Results: The initial search revealed 4404 studies, of which we included 89 qualitative studies in the scoping review. We inductively organized the patient-related factors causing barriers, as well as the facilitators to medication adherence. The studies more often dealt with barriers than facilitators. We classified the factors as patient-specific, illness-specific, medication-related, healthcare and system-related, sociocultural, as well as logistical and financial factors. Information and knowledge of diseases and their treatment, communication, trust in patient-provider relationships, support, and adequate resources appeared to be the critical facilitators in medication adherence from the patient perspective. Discussion and conclusions: Patients are willing to discuss their concerns about medications. Better communication and better information on medicines appear to be among the critical factors for patients. The findings of this scoping review may help those who plan further interventions to improve medication adherence.

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