Adherence Flashcards
What are the two parts of human cognition?
Rational brain (conscious processes)
Emotional brain (subconscious processes)
What is a the definition of NUDGE
A concept from behavioral economics and social psychology that refers to aspects of choice architecture which subtly guides people to a certain decision/choice without restricting their freedom of choice.
What are the three principles of nudge
- Make the thing easy to do i.e an inhaler a day keeps the bla bla
- Make it fun or rewarding. i.e soap with toy
- Embed it within social norms i.e most people in your area do
When/how is NUDGE used
Simple interventions targeted to a large population
What is MIND SPACE
a mnemonic to guide practitioners in applying behavioral science to influence people’s behavior in a non-coercive way
What is M in MIND SPACE
Messenger
- We are influenced by who delivers the message
- A trusted or authoritative source is more effective
What is I in MIND SPACE
Incentives
- Humans dislike losses(loss aversion)
- Intrinsic incentives(something thats good for you) are more powerful
What is N in MIND SPACE
Norms
-People are strongly influenced by what other people do and what is considered normal and people try to fit in.
- By saying other people do it makes it more likely
What is D in MIND SPACE
Defaults
- If something is the default option, we tend to go with it
- I.e like organ donation - you have to opt out of it
What is S in MIND SPACE
Salience
- is where you are drawn to something that appears novel, urgent or relevant.
- Make things stand out to ensure it is noticed
What is P in MIND SPACE
Priming
- Actions are influenced by subconscious ques like images, scents, word or triggers
- Subtle environmental cues like advertising
What is A in MIND SPACE
Affect
- Emotions lead decisions and actions
- Appealling to negative(fear) or positive emotions(hope) can be persuasive
What is C in MIND SPACE
Comittments
- People to be consistent with their comittements and tend to follow through with them
- Encourage people to make pledges (e.g no texting while driving signs)
What is E in MIND SPACE
Ego
- People act in ways that make them feel better about themselves and maintain a positive self image
- Frame behaviors in a way that fits their sense of identity such as being a ‘responsible citizen’ or caring ‘parents’ can motive their actions
What are the 3 active components in the asthma message
Salience, Incentives and Norms
What are the 3 limitations of NUDGE and MINDSPACE
- belief mismatch
- Ethical consideration(libertarian paternalism)
- Need for ‘ informed adherence
What is the belief mismatch limitation of nudge
People have have belief mismatches i.e placing bananas near till but patient may think that bananas are poisonous so still wont eat it
Essentially the behavior/choice being pushed must align with the patient’s own beliefs
What is the Ethical limitation of nudge
Is based upon libertarian paternalism, where in people are free to make their own choices, therefore nudges should not limit their free of choice and should only be used once a patient has made an informed decision to take a medicine
What is the Need for ‘ informed adherence limitation of nudge
Patient must be informed about why a medicationis necessary and nudges should just be used to help them follow through with that choice.
What are the 4 common sense defaults that undermine adherence
- NO symptoms NO problem
- Identity issues (don’t want to seem ill or dependant on medication)
- Suspicion of pharmacueticals (chemicals are bad)
- Avoid danger before gain (looking at the PIL)
What is the illness balance treatment model
a model which can help to rebrand/reframe how a patient views their illness and their treatment to create a common sense fit for the treatment.
what is step 1 in the illness treatment balance model for ICS use in asthma
Change illness perceptions
- Reframe asthma as a tendency for lungs to overreact - remove stigma away from weakness
- the body being out of balance to distinguish need for ICS
what is step 2 in the illness treatment balance model for ICS use in asthma
Change ICS perceptions
1. Increase ICS necessity (prevents underlying inflammation and damage to lungs)
2. reduce ICS concerns (natural steroid, replicates natura processes, low dose than anabolic steriods)
what is step 3 in the illness treatment balance model for ICS use in asthma
Change SABA perceptions
1. Reduce SABA necessity(only treats symptoms and not the inflammation)
2. Increase SABA concerns( overly reliant can make patient thing asthma is controlled when it is actually getting worse which is dangerous)
How to address adherence
PAPA - 3 STEP
1. perceptions - necessity
2. perceptions - concerns
3. Practicalities - tackle barriers
