Voting for Better Medication Adherence

As politicians ramp up efforts for greater voter turnout in next month’s election, it turns out that a little trick from cognitive psychology applied in get-out-the-vote drives might also work to increase medication compliance in patients. 

So what’s this intersection of voting behavior and medication adherence all about? Todd Rogers, Ph.D., an Assistant Professor of Public Policy at Harvard University, set up one of the few controlled, randomized trials related to voting to test the theory that asking people about their plans for a particular behavior could increase follow through. 

In the study, Dr. Rogers created a series of questions for potential voters to be asked, such as: 

    • What do you think you’ll be doing before you head to the polls on Tuesday? 
    • Where do you think you’ll be coming from that day? 

Unlike the usual election-time calls which simply ask the yes/no question of “do you plan to vote?” – the questions in this phone call were designed to increase turnout by helping voters form an “implementation intention.”  

As Dr. Rogers explained in his published study: “Articulating the when, where, and how of following through on an intention creates cognitive links between an anticipated future situation and the intended behavior.” In other words, the voters were directed to think about the moment of doing something – in this case, their activity just prior to voting – and that would lead to the behavior being remembered and the behavior completed in the future. 

You probably see where I am going with this voting study. Patients who are asked about activities they are engaged in around the time a medication dose is due, might be more likely to remember their medication. The activity ends up serving as a memory cue to take the medication. 

I have used this technique many times over my decades in patient care to improve medication adherence. I remember one patient in particular. She was having trouble remembering her evening medication. That is, until I asked her about her typical evening schedule and discovered that she was a dedicated viewer of the TV show “Wheel of Fortune.” Planting the seed that when Vanna flipped the letters this patient should take her pills worked like a charm. She never had trouble with medication adherence again. 

The results of Dr. Rogers’ study found that voters asked those couple of planning questions were twice as likely to end up making it to the polls, compared to voters either not asked any questions or voters simply reminded to vote. 

It’s a simple and elegant method to improve medication adherence. It’s something we’ve done for many years at BioPlus Specialty Pharmacy. We’ve seen good results with it, but it’s still nice to know that there’s now some hard science to back it up.  

Stephen C Vogt, PharmD
President and CEO
BioPlus SP

1. Nickerson DW, Rogers T. Do you have a voting plan? Implementation intentions, voter turnout, and organic plan making. Psych Sci 2010;21(2):194-9. 
2. Spiegel A. Can science plant brain seeds that make you vote? NPR. July 16, 2012.

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