A spoonful of sugar...: improving adherence to tuberculosis treatment using financial incentives.
OBJECTIVE
To determine whether incentives increase adherence to directly observed therapy (DOT) for tuberculosis (TB) treatment.


METHODS
The TB program gave a five-dollar grocery coupon for each DOT appointment kept to 55 patients who had missed at least 25% of DOT doses over a 4-week period. Treatment completion rates were compared with an historic control group of 52 patients who began treatment a year earlier, who would have been eligible for incentives but did not receive them.


RESULTS
Incentive program patients were more likely than control patients to complete therapy within 32 weeks (OR 5.73, 95%CI 2.25-14.84) and 52 weeks (OR 7.29, 95%CI 2.45-22.73).


CONCLUSIONS
Patient incentives can increase adherence to DOT in TB programs.
Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia 30303, USA. neb2@cdc.gov
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D000995:Antitubercular Agents / Q000008:administration & dosage*; D016001:Confidence Intervals; D004334:Drug Administration Schedule; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D009042:Motivation; D016017:Odds Ratio; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D014040:Token Economy; D014376:Tuberculosis / Q000188:drug therapy*; D014505:Urban Population
D000995:Antitubercular Agents