title: Outcome of a grocery voucher incentive scheme for low-income tuberculosis patients on directly observed therapy in Singapore.
abstract: BACKGROUND
  The 'DOT & Shop' scheme is sponsored by SATA CommHealth, a local non-governmental organisation. It was launched in July 2009, in collaboration with Singapore's Tuberculosis Control Unit (TBCU). Under this scheme, grocery vouchers are disbursed to low-income patients with tuberculosis (TB) at each clinic visit if they have been adherent to directly observed therapy (DOT). This study aimed to determine the effect of this incentive scheme on treatment completion rates and to report the characteristics of patients who were non-adherent to the scheme.
  
  
  METHODS
  This descriptive study used data from the TBCU medical social worker database and the National TB Registry.
  
  
  RESULTS
  From July 2009 to December 2012, a total of 883 TB patients were enrolled in the scheme. The overall treatment completion rates of the patients before (July 2006-June 2009) and after (July 2009-December 2012) the implementation of the scheme improved from 85.3% to 87.2% (p = 0.02). Patients under this scheme had a higher treatment completion rate (90.0%) than those not under this scheme (86.4%) (p < 0.01). It was found that the non-adherent patients were more likely to be of Malay ethnicity, younger and unemployed.
  
  
  CONCLUSIONS
  We demonstrate the salutary effect of a non-governmental organisation-funded grocery voucher incentive scheme for low-income TB patients on DOT in Singapore.
authors: TB Control Unit, Department of Respiratory Medicine, Tan Tock Seng Hospital, Singapore.
authors: Angeline Poh-Gek
authors: AP
authors: Chua
authors: TB Control Unit, Department of Respiratory Medicine, Tan Tock Seng Hospital, Singapore.
authors: Leo Kang-Yang
authors: LK
authors: Lim
authors: TB Control Unit, Department of Respiratory Medicine, Tan Tock Seng Hospital, Singapore.
authors: Huiyi
authors: H
authors: Ng
authors: TB Control Unit, Department of Respiratory Medicine, Tan Tock Seng Hospital, Singapore.
authors: Cynthia Bin-Eng
authors: CB
authors: Chee
authors: TB Control Unit, Department of Respiratory Medicine, Tan Tock Seng Hospital, Singapore.
authors: Yee Tang
authors: YT
authors: Wang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D016208:Databases, Factual; D023801:Directly Observed Therapy / Q000379:methods*; D005260:Female; D063105:Food Assistance; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance; D011203:Poverty; D015397:Program Evaluation; D012846:Singapore; D014376:Tuberculosis / Q000188:drug therapy*; D014478:Unemployment
chemical_list: D000995:Antitubercular Agents
keywords: DOT incentives; cultural differences; non-adherence; treatment completion rates; tuberculosis