nudge, nudge tactics, behavior modification, nonadherence, adherence. diabetes

Using Behavior Modification to Treat Diabetes

The cost of medication nonadherence, or not taking medications as prescribed, is more than $250 billion a year in the U.S. In addition, nonadherence to discharge instructions leads to hospital readmissions after surgery. That’s where nudge tactics can come in.

What are nudge tactics?

Nudge tactics are subtle ways to influence behavior through positive reinforcement and indirect suggestions. Nudging tactics can help with adherence. These tactics include buddy programs, text messages, pre-commitment strategies (signing and dating a commitment in advance), gamification (making it a game), subtle design tweaks, and written letters.

Not every nudging technique will work for every patient, which is why precision medicine, or precision engagement, is now being developed. Precision engagement tailors the nudges to each individual patient by using detailed data on the patient.


Current trials

Currently, the Penn Medicine Nudge Unit is conducting a trial researching how overweight and obese adults respond to different motivators. A similar study in precision engagement for diabetes treatment is being conducted at the Clinicas de Azucar (“Sugar Clinics”) in Mexico.

Health care practitioners are moving toward using behavioral nudges to change people’s behavior and get them to take their insulin and other medications. Behavioral nudges have been used worldwide in various circumstances, including getting cars to slow down at crosswalks by making 3-D “zebra” crossings, and sending letters to citizens in the UK to nudge them to pay their taxes.

Nudging with apps

New advancements in digital technology help patients connect with real doctors who track their progress with diabetes. Apps can nudge a patient to take their insulin, help them to take the right dosage, track their blood sugar and fasting glucose, and more. Having someone on the other end watching over what they are doing helps patients stick with their plan and be motivated to achieve better health.

With new digital health apps for diabetes, patients are motivated because they can see how they have improved over a long span of time, not only on day-to-day basis.

These studies on behavior change can lead to findings that could be applicable to other disorders, such hypertension, obesity, and substance abuse disorder. Researchers hope that using behavioral nudges will change the face of disease management.