Brooklyn-based Wellth, makers of a mobile platform designed to improve treatment adherence through behavioral economics, will be launching a National Institutes of Health-backed study on hypertension. Using their app, the company will investigate how best to incentivize hypertension patients take their medication and engage in healthier behaviors.
“Nonadherence is multifactorial — there’s a lot of different things that could be going on, and there’s been a lot of research in that area because it’s such a significant problem,” Mike Fuccillo, chief scientific officer at Wellth, told MobiHealthNews. “It could be really simple things, such as patients who have to take three different pills versus patients who take a combination pill once per day … the more inconvenient something is the more that detracts from our motivation. However, you can overcome that if you give people enough of an incentive to do the behavior.”
Wellth will be partnering with behavioral economist Uri Gneezy and and local pharmacies to enroll 100 to 200 hypertension patients into a randomized, three-arm trial: one arm will consist of the placebo group, another of patients who will be provided a cash incentive for desired behaviors, and a third group that will receive an equivalent value of pharmacy gift cards for use on health-related items.
Wellth’s platform encourages patients to take their hypertension medicine, regularly check their blood pressure, and log healthy meals over a six-week period. It does so by having the user take a photo of the specific behavior and upload it through the Wellth app. The app automatically deducts from the patient’s up-front compensation if a user fails to take the incentivized action.
Wellth’s approach to keeping patients motivated relies on a few different behavioral concepts, Fuccillo and Gordon Lanza, VP of business development at Wellth, explained. One of these is “present bias,” in which the human brain intrinsically places greater value on immediate benefits over long-term gains.
“It’s not particularly rewarding to take care of yourself if you’re very sick,” Lanza told MobiHealthNews. “A lot of these behaviors don’t have an intrinsic reward besides making you healthier in the much longer term. So what we’ve done is attached incentives to these behaviors to make them rewarding in the near term to overcome their present bias and motivate them toward healthier actions and choices now.”
The other concept under investigation is what they called “mental accounting,” in which individuals place different values on monetary value based on their presentation and use. Fuccillo and Lanza said that a major goal of their study is to see whether participants will place greater value on the flat cash reward, or on a reward specifically assigned to meet an immediate need.
Wellth’s platform has already been used to research the impact of monetary incentives, and has been used commercially to improve adherence for other conditions. However, the NIH grant does offer the company an opportunity to better understand the psychological concepts that are the core of their business.
“Research and forming a strong evidence base is core to our company, so we continually have clinical trials and pilots in new areas and disease states, and now new kinds of incentives,” Fuccillo said. “We’re continually trying to extend the ideas of providing incentives for healthy behaviors through mobile technology.”