Abstract
Purpose
In a randomised controlled trial, patients were offered financial incentives to improve their adherence to anti-psychotic maintenance medication. Compared to a control group without the incentives, they had an improved adherence and also better subjective quality of life (SQOL) after 1 year. This paper explores the question as to whether this improvement in SQOL was associated with the amount of money received or with the improved adherence itself.
Method
A secondary analysis was performed using data of the experimental group in the trial. Adherence was assessed as the percentage of all prescribed long-acting anti-psychotic injections that were taken by the patient. In regression models, we tested whether changes in medication adherence and/or the amount of incentives received over the 12-month period was associated with SQOL, as rated on the DIALOG scale.
Results
Adherence changed from 68.49 % at baseline to 88.23 % (mean difference in adherence = 19.59 %, SD = 17.52 %). The total amount of incentives received within the 1-year study period varied between £75 and £735, depending on the treatment cycle and the number of long-acting injections taken. Improvement in adherence was found to be a significant predictor of better subjective quality of life (β = 0.014, 95 % CI 0.003–0.025, p = 0.014), whilst the amount of incentives received was not (β = 0.0002, 95 % CI −0.002 to 0.002, p = 0.818).
Conclusion
Improved medication adherence is associated with a more favourable SQOL. This underlines the clinical relevance of improved adherence in response to financial incentives in this patient group.
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Funding
This trial was funded by the National Institute of Health Research Health Technology Assessment (Project No. 07/60/43). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA, NIHR, NHS, or the Department of Health.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (NRES reference number 09/H0710/35) and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
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Informed consent was obtained from all individual participants included in the study.
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Moran, K., Priebe, S. Better quality of life in patients offered financial incentives for taking anti-psychotic medication: Linked to improved adherence or more money?. Qual Life Res 25, 1897–1902 (2016). https://doi.org/10.1007/s11136-016-1238-1
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DOI: https://doi.org/10.1007/s11136-016-1238-1