title: Better quality of life in patients offered financial incentives for taking anti-psychotic medication: Linked to improved adherence or more money?
abstract: In a randomised controlled trial, patients were offered financial incentives to improve their adherence to anti-psychotic maintenance medication. Compared to a control group without the incentives, they had an improved adherence and also better subjective quality of life (SQOL) after 1 year. This paper explores the question as to whether this improvement in SQOL was associated with the amount of money received or with the improved adherence itself.
  
  
  
  A secondary analysis was performed using data of the experimental group in the trial. Adherence was assessed as the percentage of all prescribed long-acting anti-psychotic injections that were taken by the patient. In regression models, we tested whether changes in medication adherence and/or the amount of incentives received over the 12-month period was associated with SQOL, as rated on the DIALOG scale.
  
  
  
  Adherence changed from 68.49 % at baseline to 88.23 % (mean difference in adherence = 19.59 %, SD = 17.52 %). The total amount of incentives received within the 1-year study period varied between £75 and £735, depending on the treatment cycle and the number of long-acting injections taken. Improvement in adherence was found to be a significant predictor of better subjective quality of life (β = 0.014, 95 % CI 0.003-0.025, p = 0.014), whilst the amount of incentives received was not (β = 0.0002, 95 % CI -0.002 to 0.002, p = 0.818).
  
  
  
  Improved medication adherence is associated with a more favourable SQOL. This underlines the clinical relevance of improved adherence in response to financial incentives in this patient group.
authors: Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health for Service Development, Queen Mary University of London, London, UK.
authors: Katherine
authors: K
authors: Moran
authors: Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health for Service Development, Queen Mary University of London, London, UK. S.Priebe@qmul.ac.uk.
authors: Stefan
authors: S
authors: Priebe
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D011618:Psychotic Disorders / Q000188:drug therapy; D011788:Quality of Life / Q000523:psychology*
chemical_list: D014150:Antipsychotic Agents
keywords: Adherence; Anti-psychotic; Financial incentives; Psychosis; Quality of life; Schizophrenia