The Roybal Center for Therapeutic Optimization Using Behavioral Science
Center for Healthcare Delivery Sciences
Brigham and Women's Hospital
The evidence-based use of prescription medications has led to substantial improvement in healthy aging. Despite this, the use of medications by patients and providers remains suboptimal. Many patients are not prescribed guideline-recommended therapies from which they would benefit; among those for whom appropriate treatment is initiated, almost half do not adhere over the long-term; and, others receive potentialgly hazardous medications with an unfavorable balance of risks and benefits. The result: preventable adverse health outcomes and health spending for middle-aged and older adults.
While many factors influence the suboptimal use of prescription medications, individual, interpersonal and institutional behaviors are central. As a result, existing intervention to address these issues have attempted to remind, reward, motivate, simplify or otherwise change behavior. Unfortunately, these interventions have only been modestly effective and even among those that are effective, behavior change is rarely sustained over the long-term. The results can be explained by the lack of integrating behavioral principles when designing interventions, a limited focus on evaluating how to deliver them over the long term, and the inherent challenges in delivering precise and personalized behavior change at population scale.