Small nudges to improve med compliance? Maybe not.

An interesting study recently published in JAMA Internal Medicine looked at the effect of various "pill reminder" gadgets to see how much they helped patients who were deemed non-compliant with their medication. Somewhat surprisingly, the results showed that none of the tested devices really helped.

One nice feature of the study is that it tested 3 different types of reminder systems: a standard pill box, a pill container with a digital timer cap, and a bottle strip with toggles. In addition, a control group was given nothing. Unfortunately, the study

found that none of the devices boosted prescription adherence for patients with chronic disease over 12 months. A medication possession ratio greater than 80% was achieved by 15.5% of the patients in the standard pillbox group, 15.1% of the digital timer cap group, 16.3% of the pill bottle strip with toggles cohort, and 15.1% of the control group.

So, roughly 1 out of 6 patients improved their compliance - but that happened regardless of device - even the patients who were not given anything improved at the same rate.

As much as we love the idea that "one simple trick" can solve a major problem, an increasing body of evidence suggests that the kinds of consistent behavior changes we are looking to solve in healthcare require much more complex, sophisticated interventions.