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Paying Forgetful Patients To Take Their Meds
You’d think that if your life depends on you taking your medicines that it would be incentive enough. But not for some patients, whose conditions are often made worse because they forget to take their meds.
When they get really sick and "boomerang" in and out of the hospital, these forgetful patients actually cost a lot of money. So, government, insurance companies, and doctors created a counterintuitive program to coax patients to take their meds: by paying them!
In a Philadelphia program people prescribed warfarin, an anti-blood-clot medication, can win $10 or $100 each day they take the drug — a kind of lottery using a computerized pillbox to record if they took the medicine and whether they won that day.
Before the program, Chiquita Parker, a 25-year-old single mother with lupus, too ill to continue her job with special needs children, repeatedly made medication mistakes, although she knows she depends on warfarin to prevent clots than can cause strokes, paralysis, or death.
“I would forget to take it,” and feel “like I couldn’t breathe,” she said. Or she would “take two in a day,” and develop bruises from uncontrolled internal bleeding.
But in the six-month lottery program, she pocketed about $300. “You got something for taking it,” Ms. Parker said. Suddenly, she said, “I was taking it regularly, I was doing so good.”
Needless to say, the program is controversial as some view it as rewarding bad behaviors:
Skeptics question if payments can be coercive or harm doctor-patient relationships. “Why should people who don’t want to take medication be paid, when prudent people who take medication are not?” said Dr. George Szmukler, a psychiatry professor at King’s College London.
What do you think? Does the end justify the means? Is it okay to bribe patients to do something they should’ve been doing in the first place?
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