Unused Opioid Pills: Can We Pay Patients to Clean Their Medicine Cabinets?
A few weeks ago, I was chatting with another physician in the emergency department after finishing my shift. He had thrown a birthday party for his nine-year-old son Jake, who had recently recovered from a sports-related ankle fracture. “During the party, a parent pulled me aside and said he had recently injured his shoulder doing yard work,” my colleague said. “I assumed he wanted me to examine his shoulder or give him advice – but instead he explained that he didn’t have time to see his physician, and he asked whether we had any Vicodin left over from Jake’s surgery.
Sugary Drinks – You’ve Been Warned
While a tax on sugary drinks is grabbing the headlines in Philadelphia, several cities and states are exploring other interventions to curb the consumption of sugary drinks, and hopefully reap health benefits. One such proposal is to put warning labels on sugary drinks, or on the advertising for them, calling out adverse health effects, particularly obesity, diabetes and tooth decay.
Rationale and design of a randomized trial of automated hovering for post myocardial infarction patients: The HeartStrong program
Andrea B. Troxel, David A. Asch, Shivan J. Mehta, Laurie Norton, Devon Taylor, Tirza A. Calderon, Raymond Lim, Jingsan Zhu, Daniel M. Kolansky, Brian M. Drachman, Kevin G. Volpp
In the American Heart Journal, Andrea Troxel and colleagues, including Kevin Volpp, David Asch and Shivan Mehta, discuss the rationale and design of the HeartStrong program, a randomized controlled trial aimed at increasing medication adherence among patients with coronary artery disease. This trial features three main innovations: first, it uses behavioral economics concepts such as intermittent feedback, regret aversion and the entertainment value of a daily lottery; second, it automates procedures using new technology such as wireless pill bottles and remote feedback; and third...
Participation Rates With Opt-out Enrollment in a Remote Monitoring Intervention for Patients With Myocardial Infarction
Shivan J. Mehta, Andrea B. Troxel, Noora Marcus, Christina Jameson, Devon Taylor, David A. Asch, and Kevin G. Volpp
In JAMA Cardiology, Shivan Mehta and colleagues, including Andrea Troxel, David Asch and Kevin Volpp, evaluate whether an opt-out approach to enrollment, which has been shown to be effective in behavioral economics research, increases participation in a remote monitoring intervention among patients with myocardial infarction. This prospective cohort study compared enrollment rates in a remote monitoring intervention for medication adherence, using an opt-in vs an opt-out approach. Opt-in participants were recruited in the 60 days after discharge by sending a recruitment letter to...
The Influence of Sugar-Sweetened Beverage Warnings - A Randomized Trial of Adolescents’ Choices and Beliefs
Eric VanEpps and Christina Roberto
In the American Journal of Preventive Medicine, Eric VanEpps and Christina Roberto measure the extent to which health-related warning labels on sugar-sweetened beverages influence adolescents’ perceptions of different beverages and their choice of beverages. The authors conducted and analyzed an online survey of 2202 demographically diverse adolescents, aged 12-18. Participants were asked to choose a beverage in a hypothetical vending machine task, rate perceptions of different beverages and indicate their interest in coupons for beverages. The participants were randomly assigned...
LDI CHIBE Signs Singapore Research Partnership
A Nudge Toward Participation: Improving Clinical Trial Enrollment with Behavioral Economics
Eric M. VanEpps, Kevin G. Volpp, Scott D. Halpern
In Science Translational Medicine, Eric VanEpps, Kevin Volpp and Scott Halpern suggest behaviorally informed interventions, or “nudges” that might be tested and implemented to improve patient recruitment and enrollment in randomized controlled trials (RCTs). Participant recruitment represents one of the largest costs of conducting RCTs, and barriers to recruitment can generate problems of selective enrollment and under-enrollment. The authors present a taxonomy of different approaches aimed at increasing clinical trial enrollment, based on behavioral economics principles. The...
A Synchronized Prescription Refill Program Improved Medication Adherence
Jalpa A. Doshi, Raymond Lim, Pengxiang Li, Peinie P. Young, Victor F. Lawnicki, Joseph J. State, Andrea B. Troxel, and Kevin G. Volpp
In Health Affairs, Jalpa Doshi and colleagues, including Pengxiang Lee, Andrea Troxel and Kevin Volpp, evaluate whether renewing all medications at the same time from the same pharmacy improves adherence to medication regimens. Synchronizing medication refills is an increasingly popular strategy, but there has been little research regarding its effectiveness. The authors looked at a pilot refill synchronization program implemented by Humana, a large national insurer, and analyzed patients’ adherence before and after participation in the program, compared to a control group. The...
A Randomized Trial of Social Comparison Feedback and Financial Incentives to Increase Physical Activity
Mitesh S. Patel, Kevin G. Volpp, Roy Rosin, Scarlett L. Bellamy, Dylan S. Small, Michele A. Fletcher, Rosemary Osman-Koss, Jennifer L. Brady, Nancy Haff, Samantha M. Lee, Lisa Wesby, Karen Hoffer, David Shuttleworth, Devon H. Taylor, Victoria...
In the American Journal of Health Promotion, Mitesh Patel and colleagues, including Kevin Volpp, Roy Rosin, Dylan Small and David Asch, investigate the different social and financial drivers of increased physical activity. Physical activity is the leading risk factor for cardiovascular disease and mortality. This 13-week study grouped participants into 72 competing teams of four members each, tasked with walking at least 7,000 steps per days, and monitored via a smartphone application. The members were given team-based physical activity performance feedback either with or without...
Volpp and Asch Win AcademyHealth Article-of-the-Year Award
How Health May Equal Wealth For Some
The Effect of a Sunday Liquor-Sales Ban Repeal on Crime: A Triple-Difference Analysis
SeungHoon Han, Charles Branas, John MacDonald
In Alcoholism: Clinical and Experimental Research, SeungHoon Han, Charles Branas and John MacDonald investigate whether alcohol availability in state-run liquor stores affects a neighborhood’s crime rates, and if the relationship between alcohol availability and crime differs based on a neighborhood’s socioeconomic status (SES). In 2003, Pennsylvania repealed the Sunday alcohol-sales ban for a portion of its state-run stores. The authors utilized this policy change for their analysis. They find that the repeal was associated with a significant increase in total and property-crime...
Study Confirms In-Car Breathalyzers Reduce DUI Deaths
Generic Medication Prescription Rates After Health System–Wide Redesign of Default Options Within the Electronic Health Record
Mitesh Patel, Susan Day, Scott Halpern, William Hanson, Joseph Martinez, Steven Honeywell Jr, Kevin Volpp
In JAMA Internal Medicine, Mitesh Patel and colleagues, including Scott Halpern and Kevin Volpp, evaluate how changing electronic health record (EHR) defaults affects physician prescribing of generic drugs. For the study, the researchers utilized a systemic change to the University of Pennsylvania Health System’s EHR defaults. As part of this change, an opt-out checkbox labeled “dispense as written” was added to the prescription screen, and if left unchecked the generic-equivalent medication was prescribed. The authors find that generic prescribing rates increased significantly...
Applying Behavioral Economics to the Thorny Issue of Vaccine Acceptance
Can insights from behavioral economics inform creative approaches to increasing vaccination rates, and help prevent outbreaks of vaccine-preventable diseases? In a JAMA Pediatrics Viewpoint, LDI Senior Fellows Alison Buttenheim and David Asch suggest how to apply behavioral economic principles to the thorny issue of vaccine acceptance, and discuss the challenges in doing so.