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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Why not set up intervention programs such as organising a cheap clock with an alarm system that they keep in a place of prominence, or confirming that a family member will remind them when they are supposed to take their meds?

If they can remember in the event of receiving a monetary reward, they can remember without it. If that's all it takes to help them "remember" then perhaps it's not a memory problem, but more of a motivational one.
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I never said age has anything to do with it, I'm just saying that a 25 year old is a 25 year old. Disease or not, each one has it's own sense of responsibility. Havn't you heard the parrental argument that college students don't get the proper amount of sleep, and constantly skip meals? I am sorry that I didn't get my point across, we can both agree that age is meaningless, but automaticly people throw the assumption that life threatning ailment has to mean that to get on with their life they can't be as careless as anyone else in their age range.
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I understand the principle, but does it have to be so much money? Keeping forgetful people out of the hospital is a thoughtful, preventative measure to reduce overall costs, yadda yadda. I understand.

$300 in 6 months is a lot of money!
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Gualdar, don't use age (or youth in this case) as an excuse for forgetting something that important and lifesaving. There is a "mindset" but it has nothing to do with age. I do think you are right about getting their products approved faster.

On that note, I disagree with rewarding them at the cost of others if they cannot *do* for themselves. I'm with Sara B on this one, though I don't think rewarding people is the answer either.

Crazy idea...maybe we should just do what we're supposed to?
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