Can Sticker Charts Enhance Patient Adherence?

Enhancing Patients’ Treatment Adherence

I have a bit of a compulsion for adherence issues.  Going through day-to-day life, I’m on the look out for simple, practical ways to get patients to take their medication better.  My wife taught me a useful technique a few years ago.

We were trying to get our son to use the potty.  My wife got out a calendar & some stickers, and she put a sticker on the calendar for every time our son used the toilet.  He took great pride in the recognition on the calendar, plus the motivation to go to Chucky Cheese when he filled a week with stickers.  Suddenly, he was potty trained, and it only cost a few cents worth of stickers.

A sticker chart is an incredibly powerful motivator that should not be underestimated.  Humans crave positive recognition.  I think if we were to propose using a sticker chart in a research study, the human subjects research committee might reject the study on the grounds that sticker charts are overly coercive.

When caring for young children, a sticker chart may be just what the doctor ordered to get them to take their pill or to apply their topical medication.  Just a few lines drawn on a page and some culturally appropriate stickers, perhaps keeping a few different kinds on hand to account for children’s individual preferences, is a low cost, easy way that does not require a lot of time to make a big difference in adherence and treatment outcomes.


Dr. Steven Feldman is a professor of dermatology and public health sciences at Wake Forest Baptist Medical Center in Winston-Salem, NC, where he studies patients’ adherence to treatment. He is also Chief Science Officer of Causa Reseach, an adherence solutions company (, founder of and author of “Compartments” (