Tagbehavioural economics

Reading of the Week: Social Media & Paranoia — the new Acta Paper; Also, How Do We Change Docs? A Reader Responds

From the Editor

Politicians tweet about townhall meetings; celebrities put vacation pictures on Instagram; your cousin in Europe has her own YouTube channel.

Our world is very different than it was just a few short years ago. (Fun fact: Facebook – a decade and a half old – claims to have more than 2 billion active monthly users.)

But how has social media affected those with mental illness? While this is much discussed in the media, there is little in the literature. In this week’s Reading, we consider a new paper that looks at social media and mental illness, in particular psychosis. Tweet this: the University of Manchester’s Natalie Berry and her co-authors didn’t find a connection between use of social media and increased paranoia.

BELCHATOW POLAND - MAY 02 2013: Modern white keyboard with colored social network buttons.

In this week’s Reading, we consider this new paper from Acta Psychiatrica Scandinavica. We also wonder about the role of the Internet and social media for those with psychosis, drawing from a Psychiatric Services paper.

Also, the University of Toronto’s Dr. Ivan Silver writes a letter to the editor about a previous Reading.

DG

 
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Reading of the Week: How to Change Docs? Send Them a Letter. The New JAMA Psychiatry Paper on Prescribing

From the Editor

How do we get doctors to practice better medicine?

Here’s a simple idea: what if we send them a sternly written letter? In this week’s Reading, we consider a paper by Columbia University’s Adam Sacarny and his co-authors who did just that. Targeting primary care physicians who were heavily prescribing quetiapine (or Seroquel), they looked at the effects of letters written by government officials, comparing prescribing habits of these physicians with their peers. The result? In the new JAMA Psychiatry paper, they find that prescriptions of quetiapine dropped markedly.

nudge

A little nudge, better care?

The core of the idea is that a nudge – that is, the behavioural economic idea of a positive reinforcement and/or an indirect suggestion – can change outcomes. In this Reading, we consider doctors and nudges (and behavioural economics). We also look at a recent study on opioid prescribing, also involving letters.

DG

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Reading of the Week: Smoking Cessation & Incentives – the NEJM Paper

From the Editor

“So to put it simply, forcing people to choose is not always wise, and remaining neutral is not always possible.” University of Chicago economist Richard H. Thaler and Harvard Law School Professor Cass R. Sunstein write this comment in their widely-read book Nudge: Improving Decisions about Health, Wealth and Happiness. They argue that people could be nudged in a certain direction, improving outcomes. Among the book’s fans: former UK Prime Minister David Cameron and former US President Barack Obama.

Thaler and Sunstein write about shaping basic decisions, like encouraging people to choose among their company’s pension plans. Retirement planning can significantly help people with their finances in their twilight years. But what about substance use? The stakes seem higher: smoking cessation can prevent major health problems long before retirement.

This week, we look at a new paper by University of Pennsylvania Perelman School of Medicine’s Dr. Scott D. Halpern and his co-authors. Published in The New England Journal of Medicine, they consider smoking cessation and find “financial incentives added to free cessation aids resulted in a higher rate of sustained smoking abstinence than free cessation aids alone…”

file-20170804-6503-18ujgw6Nudging people to butt out?

In this week’s Reading, we consider the paper and its implications. (There is, however, no financial incentive offered here.)

DG

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Reading of the Week: Better Pay, Better Service? The CMAJ Paper on Pay for Performance in Psychiatry. Also, a Father’s Memory

From the Editor

Does pay for performance work for psychiatry?

This week’s first selection is a paper just published by CMAJ that considers that question. Drawing on Ontario data, the authors looked at practice patterns when financial incentives were introduced for psychiatrists to take care of patients after discharge and after suicide attempts. Spoiler alert: they didn’t work.

http-i-huffpost-com-gen-1291505-images-n-free-health-care-canada-628x314Paying for Performance – Getting Performance?

In this Reading, we consider the paper and the larger debate.

We also consider a short, moving essay by radio host Charles Adler on the memory of his father – and his father’s memory. The award-winning broadcaster describes his father and his Alzheimer.

DG

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Reading of the Week: NEJM and Smoking Cessation

More than 50 years after the release of the first Surgeon General’s report on the harmful effects of smoking, national policies, behavioral programs, and pharmacologic approaches have helped reduce smoking rates in the United States. However, the need for new approaches is clear because smoking remains the leading cause of preventable illness and death.

So begins a big paper from The New England Journal with a simple aim: getting people to butt out. It raises two important questions: If we are serious about promoting smoking cessation, are we willing to put ‘our money where our mouth is’ – literally? And how could we do this?

“Randomized Trial of Four Financial-Incentive Programs for Smoking Cessation” by Dr. Scott D. Halpern et al. is this week’s Reading; it has just been published.

Though other papers have been written on this topic, the Halpern et al. paper is clever and interesting – and the results are surprising.

And, don’t tell the editors of The New England Journal of Medicine: the results are also disappointing. Continue reading