At the heart of our efforts to get patients to use their medication is the need to get them to act. The motivation to act is a complex human process that is fascinating to study and understand, rich with potential practical rewards. One particularly intriguing aspect of motivation that can be harnessed to promote better adherence is illustrated by the “identifiable victim effect.”

Stats Versus Individuals

The identifiable victim effect is the tendency for people to be moved more by the experience of single identifiable victims than by large numbers of affected individuals. The quote, “A single death is a tragedy; a million deaths is a statistic,” describes the phenomenon well. Mother Teresa noted this as well when she said, “If I look at the mass, I will never act. If I look at the one, I will.”

Research studies have clearly identified and defined this attribute of human psychology.  Comedian Jon Stewart—pointing out the irony this effect has on public policy—noted that while Congressional legislators say that we must go to any length necessary to stop terrorism, heart disease kills hundreds of thousand Americans each year—and the number of Americans recently killed by terrorists or Ebola “can be counted on two Simpsons’ hands.”

Having an identifiable victim creates a picture in patients’ minds—it moves them.  Talking about statistics—particularly large numbers—may be mathematically more accurate, but wholly unmoving to human emotion.

Exemplify Good and Bad Results Surrounding Adherence

Identifiable victims can promote better adherence in several ways. By describing particular bad outcomes in patients who did not take medication as directed, patients may be moved to take medication, to take it more regularly—and to avoid overdoses. The identifiable victim effect can be extrapolated to an identifiable beneficiary effect: Telling patients (or doctors) about one particular patient who responded well may be far more moving than statistics that show that “X% of subjects in a research trial had a clinically significant improvement, with statistically significantly more having success than the subjects in the placebo group,” (a statement that could only appeal to someone immersed in clinical trial evaluation and experience, that is to say, to a nerd like me).

When presenting “data” to doctors on a new treatment option, or when educating doctors about how they can encourage better adherence in their patients, a well-painted illustrative example may be far more moving than the highest quality, bone dry clinical trial data. If you have any doubt about this, just keep an eye out for what motivates you on a day-to-day basis.

  • Steven Feldman, M.D.

    Dr. Steven Feldman is Professor of Dermatology and Public Health Sciences at Wake Forest Baptist Medical Center. Steve studies patient adherence at North Carolina’s Wake Forest Baptist Medical Center. He is also Chief Science Officer of Causa Reseach, an adherence solutions company (www.causaresearch.com), founder of www.DrScore.com, and author of “Compartments” and “An Illustrated Dictionary of Behavioral Economics for Healthcare Professionals.”

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