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CVS Caremark study: Mind games affect medication adherence

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WOONSOCKET, R.I. — A study commissioned by CVS Caremark Corp. finds that, for many people, medication adherence is a psychological game.

The drug store chain and pharmacy benefit manager said Tuesday that the study enlisted psychologists to find out if people know what motivates them to stop taking medicine, or if they don’t recognize assumptions they are making that are prompting them to stop.

Conducted by Minds at Work, a Cambridge, Mass.-based company founded by Harvard University psychologists, the study included extensive pre-interviews to find a sample of patients who said that although they wanted to follow doctors’ orders, they stopped taking prescriptions for reasons they didn’t fully understand. The psychologists conducted hour-long, "hidden motivations" interviews with those individuals to understand the underlying cause of their actions, CVS Caremark said.

Key findings included the following:

• 24% came to see that taking prescribed medications interfered with personal priorities such as taking care of family members, compromising social aspects of their lives or finding it to be just another in a long line of chores to keep track of.

• 21% felt that taking their medicine made them feel like they were losing control of their lives and sometimes by stopping their medicine they felt they were resisting authority.

• 17% felt that taking medicine gave them an unfavorable identity or made them feel old, or they wanted others to view them in a more favorable light.

• 16% believed they knew better than their doctors what was good for them, and some thought they should take care of their health through exercise and diet.

• 16% were wary of the health care and pharmaceutical industries and didn’t want to become dependent on medications or suffer unknown side effects.

• 6% didn’t want to change their personal routines and simply put off taking their medications.

"We are looking at patient nonadherence from every angle in an effort to solve this problem," explained Troy Brennan, executive vice president and chief medical officer at CVS Caremark. "We are working with researchers to study claims data. We launched a research partnership with behavioral economists and social marketing experts to understand patient behavior. This review by psychologists adds to those efforts and gives us yet another view of consumers as we work to improve pharmacy care."

CVS Caremark added that the study complements its previously announced three-year collaboration with Harvard and Brigham and Women’s Hospital to research pharmacy claims data to better understand patient behavior around medication adherence. And earlier this month the company launched a Behavior Change Research Partnership with academic leaders from Carnegie Mellon University, Dartmouth College’s Tuck School of Business and the University of Pennsylvania’s Medical School and Wharton School of Business to develop insights into consumer actions around health challenges through the lens of behavioral economics and social marketing.


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