The Differential Outcomes Procedure Enhances Adherence to Treatment: A Simulated Study with Healthy Adults

Abstract

Memory for medical recommendations is a prerequisite for good adherence to treatment, and therefore to ameliorate the negative effects of the disease, a problem that mainly affects people with memory deficits. We conducted a simulated study to test the utility of a procedure (the differential outcomes procedure, DOP) that may improve adherence to treatment by increasing the patient’s learning and retention of medical recommendations regarding medication. The DOP requires the structure of a conditional discriminative learning task in which correct choice responses to specific stimulus–stimulus associations are reinforced with a particular reinforcer or outcome. In two experiments, participants had to learn and retain in their memory the pills that were associated with particular disorders. To assess whether the DOP improved long-term retention of the learned disorder/pill associations, participants were asked to perform two recognition memory tests, 1 h and 1 week after completing the learning phase. The results showed that compared with the standard non-differential outcomes procedure, the DOP produced better learning and long-term retention of the previously learned associations. These findings suggest that the DOP can be used as a useful complementary technique in intervention programs targeted at increasing adherence to clinical recommendations.

Learning and Recall of Medical Treatment-Related Information in Older Adults Using the Differential Outcomes Procedure

“…Recently, Molina et al (2015) went further to explore whether the DOP could improve handling medication prescriptions in a group of healthy young adults. More precisely, the researchers simulated a situation where they “prescribed” participants a treatment consisting of six different drugs (or pills).…”

“… It has recently been reported that the differential outcomes procedure (DOP) might be one of the therapeutical techniques focused at promoting autonomy in the elderly to deal with their medical issues. Molina et al (2015) found that a group of healthy young adults improved their learning and long-term retention of six disorder/pill associations when each relationship to be learned was associated with a particular reinforcer (the differential outcomes condition) compared to when they were randomly administered (the non-differential outcomes condition). In the present study, we extend these findings to older adults who usually show difficulties to remember to take their medications as prescribed.…”

Enhanced learning and retention of medical information in Alzheimer’s disease after differential outcomes training

“…Memory tests were conducted 1 hour and 1 week after the learning training sessions. On the basis of the results observed by Molina et al [30] and Plaza et al [31], as well as those of other studies that have shown long-term memory improvements under the DOP (e.g., [28,32,33]), we hypothesized that patients with AD will show improved learning and long-term retention of the learned associations when they are trained with the DOP compared to when they are trained with the NOP.…”

“…Of special interest for the objectives of the present research is the study of Molina, Plaza, Fuentes, and Estévez [30] with healthy young adults. The authors used a great number of…”

Does the implicit outcomes expectancies shape learning and memory processes?

“…Previous studies have demonstrated that the DOP is effective in optimizing discriminative learning and visuospatial recognition memory in healthy people (e.g., Easton, 2004;Esteban, Vivas, Fuentes, & Estévez, 2015;Estévez et al, 2007;López-Crespo, Plaza, Fuentes, & Estévez, 2009;Martínez, Estévez, Fuentes, & Overmier, 2009;Miller, Waugh, & Chambers, 2002;Mok & Overmier, 2007;Molina, Plaza, Fuentes, & Estévez, 2015;Plaza, Estévez, López-Crespo, & Fuentes, 2011;Plaza, Molina, Fuentes, & Estévez, 2018). The DOP also helps to improve the same cognitive processes in populations with neurocognitive deficits (e.g., Carmona, Vivas, & Estévez, 2019;Esteban, Plaza, López-Crespo, Vivas, & Estévez, 2014;Estévez, Fuentes, Overmier, & González, 2003;Hochhalter, Sweeney, Bakke, Holub, & Overmier, 2000;Joseph, Overmier, & Thompson, 1997;Martínez et al, 2012;Plaza, López-Crespo, Antúnez, Fuentes, & Estévez, 2012).…”