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Offering incentives improves adherence to antipsychotic treatments

Offering “modest financial incentives” significantly improved adherence to anti-psychotic treatments, according to a study conducted by Professor Stefan Priebe of Queen Mary, University of London.

The study, published in the British Medical Journal, is a study in which patients with schizophrenia, schizoaffective disorder and bi-polar disorder, who had been prescribed and consented to long acting antipsychotic injections, were given a £15 incentive for each injection they gave themselves over a 12-month period.

At the start of the trial, average adherence to drug treatment among this group was 69 per cent, but rose to 85 per cent for the 12 months that incentives were offered.

Levels of adherence in a control group of patients who were not offered incentives increased only slightly, from 67 per cent to 71 per cent.

Patients in the incentive group were also more likely to take nearly every dose – with 28 per cent of them achieving 95 per cent adherence compared to just five per cent in the control group.

While admitting that the idea was “controversial”, Professor Stefan Priebe of Queen Mary, University of London, said that there was now “no denying” that incentives worked and called for them to be considered in scenarios where patients were being put at risk by missing doses.

However, the UK’s leading mental health charity, Mind, said that financial incentives were inappropriate because they might influence a patient’s decision to consent to a long-term drug treatment or not.

Mind say, “Antipsychotic drugs are known to have a range of potentially serious adverse affects, so should only be taken when the benefits outweigh the side effects, and not because there is a financial reward involved. People with mental health problems should be offered a wide range of treatments, not just drugs; and those taking antipsychotics should be closely monitored.”

There is currently no national guidance on financial incentives for mental health patients to encourage adherence to medication, but the National Institute of Health and Care Excellence (NICE) has recommended that “modest financial incentives” or vouchers can be offered to patients who misuse drugs in reward for “positive behaviours” such as reducing drug use.

Written by Victoria Silsbury

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