Poor patient compliance plagues medical practice, but pictures might help. A New England Healthcare Institute study in 2009 found that non-adherence to treatment plans cost up to $290 billion annually. Also, “those with low levels of adherence have almost twice the total annual health care costs of those with high levels of adherence.” ResMed presented a study in 2016 that found digital self-monitoring and clinical management significantly improved compliance. Sidekick Health reported better treatment plan adherence via wellness gamification.
Researchers at Sweden’s Umeå University published a study based on the effect of showing scary pictures to patients on their subsequent program adherence. More than 3,500 patients took part in the study: all in their 40s to 60s and with one or more cardiovascular disease risk factors. The subjects were asymptomatic at the time of the study and were divided into roughly equal intervention and control groups. Prior to any intervention, the researches administered two conventional CVD risk measurements to all patients: the Framingham risk score (FRS) and European systematic risk evaluation (SCORE). The researchers showed the patients in the intervention group ultrasound-based digital images of their own carotid atherosclerosis. Nurses made phone calls to be sure the patients understood the photos. Members of the control group were not shown scan images.
After one year, 89.9% of the original study group were re-tested with the FRS and Score instruments. The test results decreased from baseline (original) scores the for intervention group patients, but they increased from baseline for the control group. The study demonstrated significantly improved patient adherence to medication and lifestyle modifications as a result of seeing the visual representation of their plaque buildup.
Based on the Swedish study, it would be helpful if there were digital scans that showed unhealthy change for all diseases and health conditions. The larger point may be that confronting patients with objective images of harmful physical evidence of early stage disease progression could have a positive effect on future compliance. For example, it would be interesting to measure the effect on compliance of showing patients images of their failing livers, knees, lung capacity, or neural pathways if such imagery is possible.
