Many patients prescribed statins to lower cholesterol levels stop taking them within a few months. However, a new study led by researchers at the Philadelphia-based Perelman School of Medicine at the University of Pennsylvania points to a strategy that may improve compliance.
The study was the first to compare physician-only and patient-only incentives to compound physician-patient incentives.
Researchers split 340 physicians and more than 1,500 of their patients into four groups: physician-only incentives, patient-only incentives, both patient and physician incentives and no incentives.
In the physician-only group, the physicians could receive up to $1,024 per patient. In the combined incentive group, the physicians and patients split this reward. In the patient-only group, compliant patients were entered into a daily lottery with a cash reward.
The researchers found the physician-only, patient-only and no-incentive groups had similar outcomes in reaching low-density lipoprotein cholesterol goals. The group with shared incentives performed considerably better in reducing LDL cholesterol levels, though improvement was still low, at 49 percent.
"Although medication adherence was higher in the shared incentives group, it was low in all groups," said senior author Kevin Volpp, MD, PhD, a professor of medicine and healthcare management, vice chair of health policy and director of the Center for Health Incentives and Behavioral Economics at Penn Medicine, according to a statement.
"This is not surprising, since previous studies have documented poor medication adherence in patients with chronic diseases, especially where the conditions do not typically produce immediate symptoms that might motivate adherence. In addition, to be eligible for this study, patients had to be at high cardiovascular risk and yet not have their LDL at goal. That means the patients enrolled were those who were having the hardest time getting their heart disease risk down," Dr. Volpp added.
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