Evidence map›Paper›PMID 24100934›Full record

Trial reportBMJ (Clinical research ed.)2013

Effectiveness of financial incentives to improve adherence to maintenance treatment with antipsychotics: cluster randomised controlled trial.

Stefan Priebe, Ksenija Yeeles, Stephen Bremner, Christoph Lauber, Sandra Eldridge, Deborah Ashby, Anthony S David, Nicola O'Connell, Alexandra Forrest, Tom Burns

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  14. Better quality of life in patients offered financial incentives for taking anti-psychotic medication: Linked to improved adherence or more money?Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2016
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Stefan PriebeUnit for Social and Community Psychiatry, Queen Mary University of London, Newham Centre for Mental Health, London E13 8SP, UK.
Ksenija Yeeles
Stephen Bremner
Christoph Lauber
Sandra Eldridge
Deborah Ashby
Anthony S David
Nicola O'Connell
Alexandra Forrest
Tom Burns

Funding

Department of Health 07/60/43
6 · The paper itself

Abstract

objectiveTo test whether offering financial incentives to patients with psychotic disorders is effective in improving adherence to maintenance treatment with antipsychotics.

designCluster randomised controlled trial.

settingCommunity mental health teams in secondary psychiatric care in the United Kingdom.

participantsPatients with a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder, who were prescribed long acting antipsychotic (depot) injections but had received 75% or less of the prescribed injections. We randomly allocated 73 teams with a total of 141 patients. Primary outcome data were available for 35 intervention teams with 75 patients (96% of randomised) and for 31 control teams with 56 patients (89% of randomised).

interventionsParticipants in the intervention group were offered £15 (€17; $22) for each depot injection over a 12 month period. Participants in the control condition received treatment as usual.

main outcome measureThe primary outcome was the percentage of prescribed depot injections given during the 12 month intervention period.

results73 teams with 141 consenting patients were randomised, and outcomes were assessed for 131 patients (93%). Average baseline adherence was 69% in the intervention group and 67% in the control group. During the 12 month trial period adherence was 85% in the intervention group and 71% in the control group. The adjusted effect estimate was 11.5% (95% confidence interval 3.9% to 19.0%, P=0.003). A secondary outcome was an adherence of ≥ 95%, which was achieved in 28% of the intervention group and 5% of the control group (adjusted odds ratio 8.21, 95% confidence interval 2.00 to 33.67, P=0.003). Although differences in clinician rated clinical improvement between the groups failed to reach statistical significance, patients in the intervention group had more favourable subjective quality of life ratings (β=0.71, 95% confidence interval 0.26 to 1.15, P=0.002). The number of admissions to hospital and adverse events were low in both groups and did not show substantial differences.

conclusionOffering modest financial incentives to patients with psychotic disorders is an effective method for improving adherence to maintenance treatment with antipsychotics.

trial registrationCurrent Controlled Trials ISRCTN77769281.

Indexed as

Drug MonitoringIncomeMotivationRewardAdultAntipsychotic AgentsCluster AnalysisFemaleHumansMaintenance ChemotherapyMaleMiddle AgedPsychotic DisordersRegression AnalysisYoung AdultAntipsychotic Agents

Identifiers

PMID24100934
PMCPMC3805491

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.