Strategies to improve important health behaviors

Dr. Reese is keenly interested in health behavior change, particularly in the domain of medication non-adherence. Medication non-adherence is severely detrimental to health outcomes in virtually every domain of clinical medicine and may be responsible for the immense problem of incomplete transformation of research findings from clinical trials into better patient outcomes. In collaboration with Dr. Volpp and others in Penn’s Leonard Davis Institute’s Center for Health Incentives and Behavioral Economics, Dr. Reese has led or continues leading 9 randomized trials, including those focused on improving medication adherence (5), fluid intake to prevent kidney stones (1), and diet strategies (1) to reduce phosphorus in dialysis patients. These trials involved important levers of behavior change, including financial incentives as well as the efficient and creative use of technology to alert physicians to non-adherent patients. He has also developed novel methodological approaches to adapt and intensify interventions based on real-time data from wireless devices about the success of the initial intervention on behavior change. Related manuscripts have been published in the Journal of General Internal Medicine as well as the American Journal of Kidney Diseases.

• Large, multi-center, NIH-funded trial to prevent stone recurrence called PUSH (Prevention of Urinary Stones with Hydration)
• A randomized trial of automated reminders and provider notification to improve immunosuppression adherence among kidney transplant recipients
• Promote and Support randomized trials to improve adherence to statins using social forces
• Pilot RCT on improving serum phosphorus control in dialysis patients
• Two randomized controlled trials of financial incentives to lower cholesterol
  • https://clinicaltrials.gov/ct2/show/NCT02246959
  • https://clinicaltrials.gov/ct2/show/NCT01798784