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Medical and social costs after using financial incentives to improve medication adherence: results of a 1 year randomised controlled trial

OBJECTIVE: Offering a financial incentive (‘Money for Medication’) is effective in improving adherence to treatment with depot antipsychotic medications. We investigated the cost-effectiveness in terms of medical costs and judicial expenses of using financial incentives to improve adherence. The eff...

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Autores principales: Noordraven, Ernst L., Wierdsma, André I., Blanken, Peter, Bloemendaal, Anthony F. T., Mulder, Cornelis L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6131864/
https://www.ncbi.nlm.nih.gov/pubmed/30201054
http://dx.doi.org/10.1186/s13104-018-3747-1
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author Noordraven, Ernst L.
Wierdsma, André I.
Blanken, Peter
Bloemendaal, Anthony F. T.
Mulder, Cornelis L.
author_facet Noordraven, Ernst L.
Wierdsma, André I.
Blanken, Peter
Bloemendaal, Anthony F. T.
Mulder, Cornelis L.
author_sort Noordraven, Ernst L.
collection PubMed
description OBJECTIVE: Offering a financial incentive (‘Money for Medication’) is effective in improving adherence to treatment with depot antipsychotic medications. We investigated the cost-effectiveness in terms of medical costs and judicial expenses of using financial incentives to improve adherence. The effects of financial incentives on depot medication adherence were evaluated in a randomised controlled trial. Patients in the intervention group received €30 a month over 12 months if antipsychotic depot medication was accepted. The control group received mental health care as usual. For 133 patients outcomes were calculated based on self-reported service use and delinquent behaviour and expressed as standard unit costs to value resource use. RESULTS: The financial incentive resulted in higher average costs related to mental health care (€449.6 versus €355.7). and lower medical costs related to other healthcare services (€52.0 versus €78.4). Relevant differences in social costs related to delinquent behaviour were not found. Although wide confidence intervals indicate uncertainty, incremental cost-effectiveness ratio’s (ICER) indicate that it costs €2080 for achieving a 20% increase in adherence or €3332 for achieving over 80% adherence. In sum, offering money as financial incentive for increasing compliance did not lead to an overall cost reduction as compared to care as usual. Trial registration NTR2350, 01 June 2010 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13104-018-3747-1) contains supplementary material, which is available to authorized users.
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spelling pubmed-61318642018-09-13 Medical and social costs after using financial incentives to improve medication adherence: results of a 1 year randomised controlled trial Noordraven, Ernst L. Wierdsma, André I. Blanken, Peter Bloemendaal, Anthony F. T. Mulder, Cornelis L. BMC Res Notes Research Note OBJECTIVE: Offering a financial incentive (‘Money for Medication’) is effective in improving adherence to treatment with depot antipsychotic medications. We investigated the cost-effectiveness in terms of medical costs and judicial expenses of using financial incentives to improve adherence. The effects of financial incentives on depot medication adherence were evaluated in a randomised controlled trial. Patients in the intervention group received €30 a month over 12 months if antipsychotic depot medication was accepted. The control group received mental health care as usual. For 133 patients outcomes were calculated based on self-reported service use and delinquent behaviour and expressed as standard unit costs to value resource use. RESULTS: The financial incentive resulted in higher average costs related to mental health care (€449.6 versus €355.7). and lower medical costs related to other healthcare services (€52.0 versus €78.4). Relevant differences in social costs related to delinquent behaviour were not found. Although wide confidence intervals indicate uncertainty, incremental cost-effectiveness ratio’s (ICER) indicate that it costs €2080 for achieving a 20% increase in adherence or €3332 for achieving over 80% adherence. In sum, offering money as financial incentive for increasing compliance did not lead to an overall cost reduction as compared to care as usual. Trial registration NTR2350, 01 June 2010 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13104-018-3747-1) contains supplementary material, which is available to authorized users. BioMed Central 2018-09-10 /pmc/articles/PMC6131864/ /pubmed/30201054 http://dx.doi.org/10.1186/s13104-018-3747-1 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Note
Noordraven, Ernst L.
Wierdsma, André I.
Blanken, Peter
Bloemendaal, Anthony F. T.
Mulder, Cornelis L.
Medical and social costs after using financial incentives to improve medication adherence: results of a 1 year randomised controlled trial
title Medical and social costs after using financial incentives to improve medication adherence: results of a 1 year randomised controlled trial
title_full Medical and social costs after using financial incentives to improve medication adherence: results of a 1 year randomised controlled trial
title_fullStr Medical and social costs after using financial incentives to improve medication adherence: results of a 1 year randomised controlled trial
title_full_unstemmed Medical and social costs after using financial incentives to improve medication adherence: results of a 1 year randomised controlled trial
title_short Medical and social costs after using financial incentives to improve medication adherence: results of a 1 year randomised controlled trial
title_sort medical and social costs after using financial incentives to improve medication adherence: results of a 1 year randomised controlled trial
topic Research Note
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6131864/
https://www.ncbi.nlm.nih.gov/pubmed/30201054
http://dx.doi.org/10.1186/s13104-018-3747-1
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