Hostname: page-component-77c89778f8-cnmwb Total loading time: 0 Render date: 2024-07-21T00:52:29.190Z Has data issue: false hasContentIssue false

Do financial incentives increase treatment adherence in people with severe mental illness? A systematic review

Published online by Cambridge University Press:  11 April 2011

Alexandra Burton
Affiliation:
Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Unit for Social and Community Psychiatry, London (United Kingdom)
Stamatina Marougka
Affiliation:
Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Unit for Social and Community Psychiatry, London (United Kingdom)
Stefan Priebe*
Affiliation:
Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Unit for Social and Community Psychiatry, London (United Kingdom)
*
Address for correspondence: Professor S. Priebe, Unit for Social and Community Psychiatry, Newham Centre for Mental Health, Cherry Tree Way, Glen Road, London, E13 8SP (United Kingdom). Fax: +44–20–7540 2976 E-mail: s.priebe@qmul.ac.uk

Summary

Aim – To identify whether financial or material incentives improve treatment adherence in people with severe mental illness. Method – A systematic review of studies published between 1950 and 2008 was conducted. EMBASE, MEDLINE, EBM, AMED and PsycINFO were searched. Studies were included if a financial or material incentive was offered and if the sample had a severe mental illness. Results – Fourteen articles were identified; three studies on adherence to psychiatric treatment and one on physical exercise. Ten articles used incentives for adherence to substance misuse treatment programmes. In all studies, financial incentives were associated with an increase in adherence; however the effect was not always maintained once the incentive was withdrawn. Conclusion – While existing research suggests that financial incentives may improve treatment adherence in severely mentally ill populations, very few studies focus on psychiatric treatment. Further research may address the long term effectiveness of incentives on adherence in this population.

Declaration of Interest: The authors on this paper were supported by funds from the Wellcome Trust. All authors worked on a Wellcome Trust funded qualitative focus group study exploring stakeholder views on offering patients financial incentives to adhere to antipsychotic medication. Priebe is also lead applicant on a National Institute of Health Research (England) (NIHR) awarded grant to conduct a clinical trial on the use of financial incentives to achieve maintenance antipsychotic medication adherence.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Appleby, L. (2000). Safer services: conclusions from the report of the National Confidential Inquiry. Advances in Psychiatric Treatment 6, 515.CrossRefGoogle Scholar
Burns, T. (2007). Is it acceptable for people to be paid to adhere to medication? Yes. British Medical Journal 335, 232233.CrossRefGoogle ScholarPubMed
Burns, T., Catty, J., Dash, M., Roberts, C., Lockwood, A. & Marshall, M. (2007). Use of intensive case management to reduce time in hospital in people with severe mental illness: systematic review and metaregression. British Medical Journal 335, 336–336.CrossRefGoogle ScholarPubMed
Carey, K. B. & Carey, M. P. (1990). Enhancing the treatment attendance of mentally ill chemical abusers. Journal of Behavior Therapy and Experimental Psychiatry 21, 205209.CrossRefGoogle ScholarPubMed
Claassen, D., Fakhoury, W. K., Ford, R. & Priebe, S. (2007). Money for medication: Financial incentives to improve medication adherence in assertive outreach. Psychiatric Bulletin 31, 47.CrossRefGoogle Scholar
Drebbing, C. E., Van Ormer, A., Krebs, C., Rosenheck, R., Rounsaville, B., Herz, L. & Penk, W. (2005). The impact of enhanced incentives on vocational rehabilitation outcomes for dually diagnosed veterans. Journal of Applied Behavior Analysis 38, 359372.CrossRefGoogle Scholar
Fenton, S. W., Blyler, C. R. & Heinssen, R. K. (1997). Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophrenia Bulletin 23,637651.CrossRefGoogle ScholarPubMed
Gilmer, T. P., Dolder, C. R., Lacro, J. P., Folsom, D. P., Lindamer, L., Garcia, P. & Jeste, D. V. (2004). Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. American Journal of Psychiatry 161, 692699.CrossRefGoogle ScholarPubMed
Giuffrida, A. & Togerson, D. J. (1997). Should we pay the patient? Review of financial incentives to enhance patient compliance. British Medical Journal 315, 703707.CrossRefGoogle ScholarPubMed
Helmus, T. C., Schoener, E. P. & Roll, J. M. (2003). Reinforcement of counselling attendance and alcohol abstinence in a community based dual-diagnosis treatment program: a feasibility study. Psychology of Addictive Behaviors 17, 249251.CrossRefGoogle Scholar
Jochelson, K. (2007). Paying the Patient. Improving Health Using Financial Incentives. Kings FundGoogle Scholar
Killaspy, H., Bebbington, P., Blizard, R., Johnson, S., Nolan, F., Pilling, S. & King, M. (2006). The REACT study: randomised evaluation of assertive community treatment in north London. British Medical Journal 332, 815–20.CrossRefGoogle ScholarPubMed
Lacro, J. P., Dunn, L. B. & Dolder, C. R. (2002). Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature. Journal of Clinical Psychiatry 63, 892909.CrossRefGoogle ScholarPubMed
Mcdonald, H. P., Garg, A. X. & Haynes, R. B. (2002). Interventions to enhance patient adherence to medication prescriptions. Scientific review. Journal of the American Medical Association 288, 28682879.CrossRefGoogle ScholarPubMed
Messina, N., Farabee, D. & Reason, R. (2003). Treatment responsivity of cocaine-dependent patients with antisocial personality disorder to cognitive-behavioural and contingency management interventions. Journal of Consulting and Clinical Psychology 71, 320329.CrossRefGoogle Scholar
Monahan, J., Redlich, A. D., Swanson, J., Clark Robbins, P., Appelbaum, P. S., Petrila, J., Steadman, H. J., Swartz, M., Angell, B. & McNiel, D. E. (2005). Use of leverage to improve adherence to psychiatric treatment in the community. Psychiatric Services 56, 3744.CrossRefGoogle ScholarPubMed
National Institute for Clinical Excellence. (2009). Schizophrenia. Core Interventions in the Treatment and Management of Schizophrenia in Primary and Secondary Care (Update). NICE: London.Google Scholar
Nosè, M. (2008). Tolerability of antipsychotic drugs: does patient perspective deserve consideration? Epidemiologia e Psichiatria Sociale 17, 182185.CrossRefGoogle ScholarPubMed
Nosé, M., Barbui, C., Gray, R. & Tansella, M. (2003). Clinical interventions for treatment non-adherence in psychosis: meta-analysis. British Journal of Psychiatry 183, 197206.CrossRefGoogle ScholarPubMed
O'Donnell, C., Donohoe, G., Sharkey, L., Owens, N., Migone, M., Harries, R., Kinsella, A., Larkin, C. & O'Callaghan, E. (2003). Compliance therapy: A randomised controlled trial in schizophrenia. British Medical Journal 327(7419), 834.CrossRefGoogle ScholarPubMed
Olson, P.R. & Greenberg, D. J. (1979). Effects of contingency-contracting and decision-making groups with chronic mental patients. Journal of Consulting and Clinical Psychology 38, 376383.CrossRefGoogle Scholar
Post, E. P., Cruz, M. & Harman, J. (2006). Incentive payments for attendance at appointments for depression among low-income African Americans. Psychiatric Services 57, 414416.CrossRefGoogle ScholarPubMed
Priebe, S., Burton, A., Ashby, D., Ashcroft, R., Burns, T., David, A., Eldridge, S., Firn, M., Knapp, M. & McCabe, R (2009). Financial incentives to improve adherence to anti-psychotic maintenance medication in non-adherent patients – a cluster randomised controlled trial (FIAT), BMC Psychiatry [online]. Retrieved April 12, 2009, from CrossRefGoogle Scholar
Roll, J. M., Higgins, S. T., Steingard, S. & Mcginley, M. (1998) Use of monetary reinforcement to reduce cigarette smoking of persons with schizophrenia: a feasibility study. Experimental and Clinical Psychopharmacology 6, 157161.CrossRefGoogle ScholarPubMed
Roll, J. M., Chermack, S. T. & Chudzynski, J. E. (2004). Investigating the use of contingency management in the treatment of cocaine abuse among individuals with schizophrenia: a feasibility study. Psychiatry Research 125, 6164.CrossRefGoogle ScholarPubMed
Shaner, A., Roberts, L. J., Eckman, T. A., Tucker, D. E., Tsuang, J. W., Wilkins, J. N. & Mintz, J. (1997). Monetary reinforcement of abstinence from cocaine among mentally ill patients with cocaine dependence. Psychiatric Services 48, 807810.Google ScholarPubMed
Shaw, J. (2007). Is it acceptable for people to be paid to adhere to medication? No. British Medical Journal 335, 232233.CrossRefGoogle ScholarPubMed
Sigmon, S. C., Steingard, S., Badger, G. J., Anthony, S. L. & Higgins, S. T. (2000). Contingent reinforcement of marijuana abstinence among individuals with severe mental illness: a feasibility study. Experimental and Clinical Psychopharmacology 8, 509517.CrossRefGoogle Scholar
Thyer, B. A., Irvine, S. & Santa, C. A. (1984). Contingency management of exercise by chronic schizophrenics. Perceptual Motor Skills 58, 419425.CrossRefGoogle ScholarPubMed
Tidey, J. W., O'Neill, S. C. & Higgins, S. T. (2002). Contingent monetary reinforcement of smoking reductions, with and without transdermal nicotine, in outpatients with schizophrenia. Experimental and Clinical Psychopharmacology 10, 241247CrossRefGoogle ScholarPubMed
Tracy, K., Babuscio, T., Mich, C., Kiluk, B., Carroll, K. M., Petry, N. M. & Rounsaville, B. J. (2007). Contingency management to reduce substance use in individuals who are homeless with co-occurring psychiatric disorders. American Journal of Drug and Alcohol Abuse 33, 253258.CrossRefGoogle ScholarPubMed