The effect of financial incentives on patients' motivation for treatment: results of "Money for Medication," a randomised controlled trial.
The effect of financial incentives on patients' motivation for treatment: results of "Money for Medication," a randomised controlled trial.
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DOI：
10.1186/s12888-018-1730-y
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发表时间：
2018-05-24
期刊：
影响因子：
4.4
通讯作者：
Mulder CL
中科院分区：
文献类型：
--
作者：
Noordraven EL;Wierdsma AI;Blanken P;Bloemendaal AFT;Mulder CL
提供经济激励是提高服用抗精神病药物长效药物患者依从性的有效干预措施。我们评估了患者接受经济奖励后治疗的动机是否会降低。这项研究是“金钱换药”的一部分，这是一项多中心、开放标签、随机对照试验，该试验证明了经济激励对抗精神病药物储库依从性的积极影响。荷兰二级精神科护理服务的三个精神保健机构参与其中。符合条件的患者年龄在 18 至 65 岁之间，已被诊断患有精神分裂症或其他精神障碍，已服用抗精神病长效药物或有开始使用长效药物的指征，并且正在参加门诊治疗。在 12 个月的时间里，患者被随机分配接受照常治疗（对照组）或照常治疗，并为收到的每份药物提供经济奖励（如果完全合规，每月 30 欧元；干预组）。他们接受了 6 个月的随访，在此期间，没有因服用抗精神病药物而获得金钱奖励。为了评估 0、12 和 18 个月后的治疗动机，我们使用国家健康结果量表 (HoNOS) 和治疗进入问卷 (TEQ) 的补充进行了访谈。患者被随机分配到干预组（n = 84）或对照组（n = 85）。 12 个月后，131 名患者 (78%) 获得了 HoNOS 动机评分。百分之九十一的患者对于整体治疗没有或有轻微的动机问题；随着时间的推移，干预组和对照组之间没有显着差异。 TEQ 数据可用于一个患者亚组 (n = 61)，并且随着时间的推移，干预组和对照组之间的外部动机没有显着差异 (β = 0.37 95% CI: -2.49 – 3.23，p = 0.799)；内射动机（β = − 2.39 95% CI：-6.22 – 1.44，p = 0.222）；并确定动机（β = − 0.91 95% CI：-4.42 – 2.61，p = 0.613）。 6 个月的随访期后，HoNOS 和 TEQ 评分的结果仍然具有可比性。为服用抗精神病药物长效药物提供经济奖励并不会降低患者的治疗动机。荷兰 试验注册，编号 NTR2350。
Offering financial incentives is an effective intervention for improving adherence in patients taking antipsychotic depot medication. We assessed whether patients’ motivation for treatment might be reduced after receiving financial rewards. This study was part of Money for Medication, a multicentre, open-label, randomised controlled trial, which demonstrated the positive effects of financial incentives on antipsychotic depot compliance. Three mental healthcare institutions in Dutch secondary psychiatric care services participated. Eligible patients were aged 18–65 years, had been diagnosed with schizophrenia or another psychotic disorder, had been prescribed antipsychotic depot medication or had an indication to start using depot medication, and were participating in outpatient treatment. For 12 months, patients were randomly assigned either to treatment as usual (control group) or to treatment as usual plus a financial reward for each depot of medication received (€30 per month if fully compliant; intervention group). They were followed up for 6 months, during which time no monetary rewards were offered for taking antipsychotic medication. To assess treatment motivation after 0, 12 and 18 months, interviews were conducted using a supplement to the Health of the Nation Outcome Scales (HoNOS) and the Treatment Entry Questionnaire (TEQ). Patients were randomly assigned to the intervention (n = 84) or the control group (n = 85). After 12 months, HoNOS motivation scores were available for 131 patients (78%). Ninety-one percent of the patients had no or mild motivational problems for overall treatment; over time, there were no significant differences between the intervention and control groups. TEQ data was available for a subgroup of patients (n = 61), and showed no significant differences over time between the intervention and control groups for external motivation (β = 0.37 95% CI: -2.49 – 3.23, p = 0.799); introjected motivation (β = − 2.39 95% CI: -6.22 – 1.44, p = 0.222); and identified motivation (β = − 0.91 95% CI: -4.42 – 2.61, p = 0.613). After the 6-month follow-up period, results for the HoNOS and TEQ scores remained comparable. Offering financial incentives for taking antipsychotic depot medication does not reduce patients’ motivation for treatment. Netherlands Trial registration, number NTR2350.
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影响因子：
3.1
作者：
Moller, Arlen C.;Buscemi, Joanna;Spring, Bonnie
通讯作者：
Spring, Bonnie
影响因子：
64.3
作者：
Noordraven, Ernst L.;Wierdsma, Andre I.;Mulder, Cornelis L.
通讯作者：
Mulder, Cornelis L.
影响因子：
10.5
作者：
Bebbington, P;Brugha, T;Window, S
通讯作者：
Window, S
影响因子：
3.8
作者：
Jochems, Eline C.;Mulder, Cornelis L.;van Dam, Arno
通讯作者：
van Dam, Arno
影响因子：
105.7
作者：
Priebe, Stefan;Yeeles, Ksenija;Burns, Tom
通讯作者：
Burns, Tom