MAR: A Study of the Impact of Positive and Negative Reinforcement on Medication Adherence Reminders

This study investigates the effectiveness of three versions of a mobile persuasive application called Medication Adherence Reminder (MAR) in promoting medication adherence level among patients. MAR-1 offers a reminder feature, similar to most mobile applications on the market today, and a medications history, intended to promote self-awareness of medication adherence behavior. MAR-2 adds a points system to reward adherence, while MAR-3 adds a demerit system to punish nonadherence. An experimental comparative approach was employed to evaluate and compare the effectiveness of the three versions of MAR. The sample consisted of 30 participants over 18 years of age and on long-term medication regimens. A four-week field study with 10 participants for each MAR version was conducted. The majority of the participants found the app useful in helping them stick to their prescriptions. Most importantly, both the reward and penalty features were found to promote medication adherence behavior above the MAR-1 baseline level. While participants favored rewards over penalty, no statistically significant difference in medication adherence was found between the two approaches.