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[e-drug] promoting adherence

E-DRUG: promoting adherence

I will give some general comments about promotion that may help answer David
Green's questions about the promotion of "adherence".

Studies of promotional techniques often find that they make little
difference when tested on their own in inadequate doses.  However when used
in combination in adequate doses with frequent enough repetition for
adequate durations they can be very effective. (This is very similar to what
works and does not work for antiviral treatment of HIV!)

One important promotional technique is social validation (peer pressure). We
are mostly social (herd) animals.  Social validation leads to more success
for the successful but more failure for the unsuccessful.  People will do it
because others are doing it once you reach the tipping point. (There is a
book about the tipping point concept) Once the majority are doing it more
resources can be focused on the minority who are not yet doing  it until
they do.

I do not know if any of the above helps explain why there is success in
South Africa with techniques that are not so successful elsewhere.  However
I hope it helps provide some things to look for.



Dr Peter R Mansfield
Research Fellow, Department of General Practice, University of Adelaide
NHMRC Public Health Postgraduate Scholarship 250465
Director, Healthy Skepticism Inc
Improving health by reducing harm from misleading drug promotion.
34 Methodist St, Willunga SA 5172 Australia
ph/fax +61 8 8557 1040

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