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Patient paid to accept neuroleptic depot injection

Posted by ed_uk on January 5, 2007, at 18:47:06

From PJOnline.........

Financial incentives may improve patients’ adherence to their antipsychotic medication

Financial incentives to encourage patients to adhere to antipsychotic medication might help them stay out of hospital, according to UK researchers (Psychiatric Bulletin 2007;31:4). However, their conclusions are reached from limited data.

The researchers, based in East London, explored the use of direct financial incentives through questionnaires sent to 150 assertive outreach teams in England and by offering payments of £5–£15 to five formerly non-adherent patients for single depot injections of their antipsychotic medication.

The researchers surmised from the 70 questionnaire responses returned that attitudes towards the approach are generally negative. Most outreach team managers (76 per cent) had objections to such schemes and just under half (42 per cent) considered the approach unethical.

However, the researchers say that patients who accepted the offer of payment (four of the five patients in the study) had improved adherence to their medication and three of the patients have not been admitted to hospital since entering the scheme.

The researchers concede that there are a number of practical issues that need to be addressed if this scheme is to become widespread. They conclude: “Financial incentives might be a treatment option for a high-risk group of non-adherent patients for whom all other interventions to achieve adherence have failed.”

Graham Parton, chairman of the UK Psychiatric Pharmacy Group, commented: “Although this small study does not tell us a great deal in terms of the effectiveness of using financial incentives to improve adherence, it does raise the premise that it could be an attractive option and is certainly worth exploring.”

David Taylor, chief pharmacist, South London and Maudsley NHS Trust, added: “There will be numerous viewpoints on the ethics of such a practice but it would be best first to establish whether or not the practice is effective — as with any other untested intervention. The ethical standpoint is partly determined by the likely outcome. This study does not inform debate in this respect.”


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poster:ed_uk thread:719688
URL: http://www.dr-bob.org/babble/20070101/msgs/719688.html