Jared M Bruce1, Amanda S Bruce2,3, Delwyn Catley1, Sharon Lynch4, Kathleen Goggin5, Derek Reed6, Seung-Lark Lim1, Lauren Strober7, Morgan Glusman1, Abigail R Ness1, David P Jarmolowicz6. 1. University of Missouri-Kansas City, Kansas City, MO, USA. 2. Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Blvd Mail Stop 4004, Kansas City, KS, 66160, USA. abruce@kumc.edu. 3. Children's Mercy Hospital, Kansas City, MO, USA. abruce@kumc.edu. 4. Department of Neurology, University of Kansas Medical Center, Kansas City, KS, 66160, USA. 5. Children's Mercy Hospital, Kansas City, MO, USA. 6. University of Kansas, Lawrence, KS, USA. 7. Kessler Foundation, West Orange, NJ, USA.
Abstract
INTRODUCTION: Nearly 50 % of patients with chronic medical illness exhibit poor treatment adherence. When making treatment decisions, these patients must balance the probability of current side effects against the probability of long-term benefits. This study examines if the behavioral economic construct of probability discounting can be used to explain treatment decisions in chronic disease. METHODS: Thirty-eight nonadherent and 39 adherent patients with multiple sclerosis (MS) completed a series of hypothetical treatment scenarios with varied risk and benefit probabilities. RESULTS: As described by a hyperbolic probability discounting model, all patients reported decreased medication initiation as the probability of treatment efficacy decreased and the probability of treatment side effects increased. When compared to adherent patients, nonadherent patients significantly devalued treatment efficacy and inflated treatment risk. DISCUSSION: The methods in this study can be used to identify optimal risk/benefit ratios for treatment development and inform the process by which patients make treatment decisions.
INTRODUCTION: Nearly 50 % of patients with chronic medical illness exhibit poor treatment adherence. When making treatment decisions, these patients must balance the probability of current side effects against the probability of long-term benefits. This study examines if the behavioral economic construct of probability discounting can be used to explain treatment decisions in chronic disease. METHODS: Thirty-eight nonadherent and 39 adherent patients with multiple sclerosis (MS) completed a series of hypothetical treatment scenarios with varied risk and benefit probabilities. RESULTS: As described by a hyperbolic probability discounting model, all patients reported decreased medication initiation as the probability of treatment efficacy decreased and the probability of treatment side effects increased. When compared to adherent patients, nonadherent patients significantly devalued treatment efficacy and inflated treatment risk. DISCUSSION: The methods in this study can be used to identify optimal risk/benefit ratios for treatment development and inform the process by which patients make treatment decisions.
Entities:
Keywords:
Behavioral economics; Compliance; Medical decision-making; Multiple sclerosis; Probability discounting; Temporal discounting; Treatment adherence
Authors: Jared M Bruce; Amanda S Bruce; Sharon Lynch; Joanie Thelen; Seung-Lark Lim; Julia Smith; Delwyn Catley; Derek D Reed; David P Jarmolowicz Journal: Psychopharmacology (Berl) Date: 2018-09-22 Impact factor: 4.530
Authors: Anne Christin Rahn; Alessandra Solari; Heleen Beckerman; Richard Nicholas; David Wilkie; Christoph Heesen; Andrea Giordano Journal: Int J MS Care Date: 2020-12-28
Authors: Hiba El Masri; Treasure M McGuire; Christine Dalais; Mieke van Driel; Helen Benham; Samantha A Hollingworth Journal: J Med Libr Assoc Date: 2022-04-01