Beating the Odds of Winning the Lottery

A daily lottery was organized at a heart management center with gains ranging from $10 to $100. Only patients who had taken their heart medication as prescribed that day could collect their rewards when winning. 

Challenge

Patients take heart medication to prevent heart attacks, strokes, and blood clots, and often have to adjust their dosage to manage clotting levels. Whilst a lack of adherence reduces the medicine effectiveness and increases the risk of clotting, the effects of a missed dose can be hard for patients to gage and maintaining a medication routine can be challenging especially for those who have chronic illnesses.

Insights

We partnered with an Anticoagulation Management Center to provide patients with a medication monitor system, connected to a phone line, which had a display screen and compartments for medication. A subset of patients was enrolled in a daily lottery administered via the monitor and had a 1 in 5 chance of winning $10, and a 1 in 100 chance of winning $100 each day that they followed their warfarin regimen correctly. Every morning, the monitor notified patients whether they had won and the amount of their putative winnings, depending on whether they taken their medication correctly or not.

Impact 

Among patients designated as being high-risk, enrollment in a daily lottery significantly helped them better manage their blood coagulation levels, reducing their odds of falling outside of the acceptable range.