Evidence map›Paper›PMID 28851345›Full record

Trial reportBMC psychiatry2017

Ethical acceptability of offering financial incentives for taking antipsychotic depot medication: patients' and clinicians' perspectives after a 12-month randomized controlled trial.

Ernst L Noordraven, Maartje H N Schermer, Peter Blanken, Cornelis L Mulder, André I Wierdsma

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

Trial report in BMC psychiatry, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 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

11 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ernst L NoordravenDual Diagnosis Center (CDP) Palier, Parnassia Psychiatric Institute, 2552 KS, The Hague, The Netherlands. e.noordraven@erasmusmc.nl.ORCID 0000-0003-4287-7647
Maartje H N SchermerDepartment of Psychiatry, Erasmus University Medical Center, Epidemiological and Social Psychiatric Research Institute, 3015CE, Rotterdam, The Netherlands.
Peter BlankenParnassia Addiction Research Centre (PARC), Brijder Addiction Treatment, Parnassia Psychiatric Institute, 2553 RJ, The Hague, The Netherlands.
Cornelis L MulderDepartment of Psychiatry, Erasmus University Medical Center, Epidemiological and Social Psychiatric Research Institute, 3015CE, Rotterdam, The Netherlands.
André I WierdsmaDepartment of Psychiatry, Erasmus University Medical Center, Epidemiological and Social Psychiatric Research Institute, 3015CE, Rotterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA randomized controlled trial 'Money for Medication'(M4M) was conducted in which patients were offered financial incentives for taking antipsychotic depot medication. This study assessed the attitudes and ethical considerations of patients and clinicians who participated in this trial.

methodsThree mental healthcare institutions in secondary psychiatric care in the Netherlands participated in this study. Patients (n = 169), 18-65 years, diagnosed with schizophrenia, schizoaffective disorder or another psychotic disorder who had been prescribed antipsychotic depot medication, were randomly assigned to receive 12 months of either treatment as usual plus a financial reward for each depot of medication received (intervention group) or treatment as usual alone (control group). Structured questionnaires were administered after the 12-month intervention period. Data were available for 133 patients (69 control and 64 intervention) and for 97 clinicians.

resultsPatients (88%) and clinicians (81%) indicated that financial incentives were a good approach to improve medication adherence. Ethical concerns were categorized according to the four-principles approach (autonomy, beneficence, non-maleficence, and justice). Patients and clinicians alike mentioned various advantages of M4M in clinical practice, such as increased medication adherence and improved illness insight; but also disadvantages such as reduced intrinsic motivation, loss of autonomy and feelings of dependence.

conclusionsOverall, patients evaluated financial incentives as an effective method of improving medication adherence and were willing to accept this reward during clinical treatment. Clinicians were also positive about the use of this intervention in daily practice. Ethical concerns are discussed in terms of patient autonomy, beneficence, non-maleficence and justice. We conclude that this intervention is ethically acceptable under certain conditions, and that further research is necessary to clarify issues of benefit, motivation and the preferred size and duration of the incentive.

trial registrationNederlands Trial Register, number NTR2350 .

Indexed as

Attitude of Health PersonnelMotivationPatient Acceptance of Health CareRewardAdultAntipsychotic AgentsDelayed-Action PreparationsFemaleHumansMaleNetherlandsSchizophreniaSurveys and QuestionnairesTreatment OutcomeAntipsychotic AgentsDelayed-Action PreparationsAntipsychotic depot medicationEthicsFinancial incentivesSchizophrenia

Identifiers

PMID28851345
PMCPMC5576283

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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.