Improving Outcomes in Adults with Atopic Dermatitis: Advanced Approaches to Adherence Part IV of IV

AD Figure

This is the fourth and final part of this series on improving outcomes in atopic dermatitis (AD). We covered foundational and basic strategies for improving adherence, including establishing a positive patient-provider relationship, frequent check-ins, patient input into treatment options, streamlining treatment regimens, and medication reminders. This section will focus on more advanced techniques for improving adherence (Figure 1).

Psychological techniques can encourage patients to take medications. The concept of anchoring is relevant in nearly every decision we make. It is based on how one piece of information (the anchor) will affect how we evaluate another piece of information. Anchoring is one of the key concepts used in sales because it is so successful.

Improving Outcomes in Adults with Atopic Dermatitis: Basic Approaches to Adherence Part III of IV
Improving Outcomes in Adults with Atopic Dermatitis: Building a Foundation
Improving Outcomes in Adults with Atopic Dermatitis: Part I – Impact of Nonadherence
For example, a customer sees an advertisement for a watch on sale. The watch is regularly priced at $400 but for today only it is marked down to $100. A customer would be inclined to purchase the watch and take advantage of this great deal. In another scenario, the same watch is priced at $95, but yesterday it was priced at $45. Objectively, the price of the watch in the second scenario is better compared to price in the first scenario, but due to anchoring we are more likely to choose the first watch.  

In medicine, we can tap into the concept of anchoring to help patients overcome treatment anxiety. The mention of an injectable medication may incite fear and anxiety in patients. In 2017, we performed a study that assessed the effects of anchoring on patients’ willingness to use injectable medications.1 We divided 2 groups of participants into a control group (no anchoring question) and intervention group (anchoring question). In the intervention group, 50 participants were asked “how willing are you to receive a daily injection?” followed by “how willing are you to take a monthly injection?” The control group was only asked whether they would be willing to receive a monthly injection. For many participants, their level of willingness was low. However, in comparisons between the control group and intervention group, participants who received the anchor question were 4 times more willing to receive monthly injections.

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