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Financial incentives improve adherence to maintenance antipsychotic treatment

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Question: Does a financial incentive improve adherence to maintenance antipsychotic treatment?

Patients: 141 adults (mean age 43.7 years) diagnosed with bipolar disorder, schizophrenia or schizoaffective disorder (ICD-10), under the care of a mental health team for at least 4 months, and who were less than 75% report with their prescriptions for long-acting (depot) antipsychotic injections. Exclusions: intellectual disability or limited English.

Setting: Secondary care community mental health teams, UK; recruitment April 2010 to November 2011.

Intervention: Financial incentive of 15GBP cash for every attendance for depot injection versus treatment as usual, for 12 months. Randomisation was by mental health team (total 73) rather than by individual to avoid different treatment of patients within each team, which may have caused problems among patients, and to prevent contamination of practice.

Outcomes: Primary outcome: percentage adherence to depot injections. Secondary outcomes: percentage of patients with 95% compliance; clinician-rated clinical global improvement at 12 months (clinical global impression …

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