Being Kind to Your Future Self: Probability Discounting of Health Decision-Making.
INTRODUCTION
Nearly 50 % of patients with chronic medical illness exhibit poor treatment adherence. When making treatment decisions, these patients must balance the probability of current side effects against the probability of long-term benefits. This study examines if the behavioral economic construct of probability discounting can be used to explain treatment decisions in chronic disease.


METHODS
Thirty-eight nonadherent and 39 adherent patients with multiple sclerosis (MS) completed a series of hypothetical treatment scenarios with varied risk and benefit probabilities.


RESULTS
As described by a hyperbolic probability discounting model, all patients reported decreased medication initiation as the probability of treatment efficacy decreased and the probability of treatment side effects increased. When compared to adherent patients, nonadherent patients significantly devalued treatment efficacy and inflated treatment risk.


DISCUSSION
The methods in this study can be used to identify optimal risk/benefit ratios for treatment development and inform the process by which patients make treatment decisions.
['Bruce|Jared M|JM|', 'Bruce|Amanda S|AS|', 'Catley|Delwyn|D|', 'Lynch|Sharon|S|', 'Goggin|Kathleen|K|', 'Reed|Derek|D|', 'Lim|Seung-Lark|SL|', 'Strober|Lauren|L|', 'Glusman|Morgan|M|', 'Ness|Abigail R|AR|', 'Jarmolowicz|David P|DP|']
D000328:Adult D003657:Decision Making D065786:Delay Discounting D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009103:Multiple Sclerosis D010349:Patient Compliance D012201:Reward D016896:Treatment Outcome
Probability discounting Treatment adherence Behavioral economics Multiple sclerosis Compliance Medical decision-making Temporal discounting