New research by Boots UK, University College London, and Columbia Business School (US) has applied behavioral nudge theory to improve medication adherence. The nudge theory proposes positive reinforcement and indirect suggestions as ways to influence the behavior and decision making of the patient and came about as a result of the researchers’ aim to understand why patients were failing to adhere to their medication prescriptions.They then tested different behavioral ‘nudges’, or subtle changes to the patient’s environment, to find the best ways of boosting compliance.

The research claimed that one way to motivate patients to take their medicines as prescribed is to ask them to make a commitment based on the personal health consequences of not taking their medicines properly; such as missing doses, not finishing a course of treatment or not taking the right dosage.
As part of the study, pharmacists asked patients to sign a sticker committing themselves to completing their medication, which was affixed to their medication packaging. Those patients who signed their name to one of these stickers which included a message warning them of the adverse consequences to their own health of non-adherence were found to be significantly more likely to adhere to their medication than other patients, including those who signed stickers warning them of the financial costs to society.

Marc Donovan, chief pharmacist at Boots, said: “As Pharmacists, we know the importance of the correct use of medicines by patients. The impact of non-adherence to medication is widespread, and the result of poor compliance is a key public health issue. He continued, “We want to act quickly to find ways that the pharmacy profession can help boost the public’s understanding of medicines and ultimately improve adherence. This study is important in looking at how community pharmacy can take the lead on this issue by using simple behavioral nudge theories, ultimately helping make important services like the New Medicine Service more effective for patients as well as saving the NHS money.”

Following the results of this study, Boots is working with a multidisciplinary team of researchers at University of Nottingham to understand the mechanisms behind the nudge messages and how they could be introduced into wider community pharmacy practice.