“Don’t focus on benefits. Increase compliance by empathizing with the patient to identify and overcome the barriers,” says Punam Keller, Associate Dean for Innovation and Growth at the Tuck School of Business at Dartmouth College. To illustrate this point, Keller shares her experience with one heart failure patient who was worried about going home. He understood the three seemingly simple instructions he had to follow: take his prescription medications, limit his fluid intake, and weigh himself. But when Keller asked which he was most concerned with, she learned that taking prescription medications — a typical barrier — wasn’t it. He was more concerned with weighing himself.
“Remember, as a social marketer, you don’t make assumptions,” says Keller. When she asked the patient why weighing himself was difficult, he had her sit down and told her to weigh herself. When she stood up, the patient pushed her back down. “You can’t get up,” he said. Keller realized that for those who are bedridden or wheelchair bound, stepping on the scale is a real challenge. This experience sparked the idea for a study on reducing 30-day heart failure readmission rates by understanding patients’ barriers to compliance in context.
From the NEJM Catalyst event Patient Engagement: Behavioral Strategies for Better Health at the University of Pennsylvania, February 25, 2016. Watch Part 1, Part 3, and Part 4 of Keller’s talk.