Comparing Differing Financial Incentive Structures for Increasing Antidepressant Adherence Among Adults

Not Applicable

Completed

• Conditions: Depression
• Interventions: Other: Financial incentives

• Registration Number: NCT03441399
• Lead Sponsor: University of Pennsylvania

Brief Summary

The investigators will test using financial incentives by leveraging decision-making biases to improve adherence to antidepressants among adults newly prescribed antidepressants. This study will compare the effects of usual care, increasing financial incentives, and decreasing financial incentives on daily antidepressant medication adherence and depression symptom control of non-elderly adults with Major Depressive Disorder.

Detailed Description

A three arm randomized controlled trial will compare interventions to promote antidepressant adherence. One hundred twenty adults with major depressive disorder (MDD) who are initiating antidepressant treatment will be randomized in equal proportion to 1) usual care, 2) usual care and an escalating daily financial incentive for 6 weeks, or 3) usual care and a de-escalating financial incentive for daily antidepressant adherence for 6 weeks. Study patients will participate in three assessments over a 12 week period as well as passive monitoring of antidepressant daily adherence through a wireless electronic pill bottle over the same 12 week period. The primary outcome will be the number of antidepressant daily doses taken during the initial six weeks of treatment. The secondary outcome will be daily adherence during the next six weeks following the discontinuation of the intervention.

Study Timeline

• Study First Submitted: 2018-02-15
• Study First Submitted QC: 2018-02-15
• Study First Posted: 2018-02-22
• Study Start: 2018-03-01
• Primary Completion: 2019-09-26
• Study Completion: 2019-09-26
• Status Verified: 2019-10
• Last Update Submitted: 2019-10-14
• Last Update Posted: 2019-10-15

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 120

Inclusion Criteria

• Prescribed antidepressant
• Plan to take antidepressant as prescribed
• Working cell phone that allows texting
• Score on PHQ-9 ≥ 10

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Exclusion Criteria

• No antidepressant use in last 90 days
• Never been diagnosed with bipolar disorder, schizophrenia, or schizoaffective disorder
• Not currently pregnant or breastfeeding
• No other serious medical condition

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Escalating Incentives	Financial incentives	Participants assigned to the escalating financial incentives will receive an increasing financial incentive for taking their antidepressant medication for the initial 6 weeks of treatment.
De-escalating Incentives	Financial incentives	Participants assigned to the de-escalating financial incentives will receive a decreasing financial incentive for taking their antidepressant medication for the initial 6 weeks of treatment.

Primary Outcome Measures

Name	Time	Method
Antidepressant adherence	Daily for first 6 weeks of study	The number of antidepressant daily doses taken during the initial six weeks of treatment

Secondary Outcome Measures

Name	Time	Method
Depression symptoms	At baseline, 6 week follow-up, and 12 week follow-up	Severity of depressive symptoms as assessed by the Patient Health Questionnaire (PHQ-9). The PHQ-9 measures depressive symptoms, with scores ranging from 0-27 (higher scores meaning more depressive symptoms).
Antidepressant adherence post-intervention	Daily between 6 and 12 weeks	The number of antidepressant daily doses taken between 6 and 12 weeks

Trial Locations

Locations (1)

University of Pennsylvania Health System; 🇺🇸 Philadelphia, Pennsylvania, United States