Positive reinforcement, such as receiving small, unexpected gifts and introducing upbeat thoughts into daily routines, seems to help patients with high blood pressure take their medication as directed, according to a new study of black Americans.

The findings are significant because poor blood pressure control can lead to heart problems and death, the researchers from the Center for Healthful Behavior Change at NYU School of Medicine noted in the report published online Jan. 23 in the Archives of Internal Medicine.

For the study, Dr. Gbenga Ogedegbe and colleagues examined 256 black patients with high blood pressure (also called hypertension) to determine if positive reinforcement in addition to patient education would help them follow their treatment plans and take their medication correctly.

The researchers divided the patients into two groups: those who only received patient education; and those who received positive reinforcement as well as patient education.

Both groups received educational materials, including a self-management workbook, a behavioral contract and two phone calls each month.

However, patients who received additional positive reinforcement were given an extra chapter in their workbook that discussed how positive moments could be used to help them stick to their treatment plans.

In addition, during their semi-monthly phone calls, these patients were asked to remember positive moments in their lives and use those optimistic feelings to help them overcome any challenges that made it hard to take their medicine. This group was also given token, unexpected gifts in the mail before their phone calls.

The investigators found that medication adherence at one year was higher in the positive reinforcement plus education group (42 percent) than in the education-only group (36 percent).

“Our findings suggest that [patient education] enhanced with behavioral constructs drawn from positive psychology and designed to foster [self-affirmation] produced significantly greater medication adherence in hypertensive African Americans than [patient education] alone,” the authors wrote in a journal news release.

The study authors noted that more research is needed to determine if incorporating positive reinforcement into treatment for high blood pressure would be cost-effective.

More information

The U.S. National Library of Medicine has more about hypertension.

– Mary Elizabeth Dallas

SOURCE: JAMA/Archives, news release, Jan. 23, 2012

Last Updated: Jan. 27, 2012