Don’t Nudge Me: The Limits of Behavioral Economics in Medicine<br />A more recent Cochrane review concluded that “current methods of improving medication<br />adherence for chronic health problems are mostly complex and not very effective.”<br />At first glance, behavioral economics — the basis of Richard Thaler’s recent<br />Nobel Prize in Economics — seems like a rich field of potential solutions.<br />Those patients who took their drugs were entered into a lottery in which they had a 20 percent chance to receive $5<br />and a 1 percent chance to win $50 every day for a year.<br />A thorough review published in The New England Journal of Medicine about a decade ago estimated<br />that up to two-thirds of medication-related hospital admissions in the United States were because of noncompliance, at a cost of about $100 billion a year.<br />Get the Upshot in your Inbox<br />Whenever I talk to physicians about outcomes that are worse than you’d expect, they are quick to point out<br />that noncompliance — when a patient does not follow a course of treatment — is a major problem.<br />The lottery group members could also sign up to have a friend or family member automatically<br />be notified if they didn’t take their pills so that they could receive social support.<br />A systematic review published five years ago in Annals of Internal Medicine looked at all kinds of trials that tried to improve patient compliance.
