Leveraging behavioral economics to promote treatment adherence: A primer for the practicing dermatologist

J Am Acad Dermatol. 2022 Nov;87(5):1075-1080. doi: 10.1016/j.jaad.2021.05.049. Epub 2021 Jun 5.

Abstract

The problem of suboptimal treatment adherence among patients with dermatologic or other diseases has not been adequately addressed in health care. Despite a wide range of efficacious therapies, nonadherence remains a primary driver of suboptimal clinical outcomes. Novel solutions to address this unmet need can be found in behavioral economics. By leveraging our understanding of human decision-making, we may better promote treatment adherence, thereby improving quality of life and decreasing economic burdens. Behavioral economics has been studied extensively in relation to topics such as health policy and health behaviors; however, there is a dearth of research applying this approach to chronic diseases and only a handful within dermatology. We conducted a scoping review in PubMed to identify articles that discuss behavioral economics and its application to treatment adherence in dermatologic patients, with a particular focus on psoriasis, followed by a summary of key ethical considerations. We found that such principles can be employed in cost-effective, scalable interventions that improve patient adherence to a range of medical therapies and lifestyle modifications.

Keywords: adherence; anchoring; behavioral economics; decoy effect; dermatology; framing; incentives; loss aversion; precommitment; present bias; psoriasis; quality-of-life; regret aversion; status quo bias; treatment outcome.

Publication types

  • Review

MeSH terms

  • Dermatologists
  • Economics, Behavioral*
  • Health Behavior
  • Humans
  • Medication Adherence
  • Patient Compliance
  • Quality of Life*