Comparing Differing Financial Incentive Structures for Increasing Antidepressant Adherence Among Adults (ADAPT)

University of Pennsylvania

Status: Completed

Conditions: Depression

Treatments: Other: Financial incentives

Study type: Interventional

Funder types: Other

Identifiers

NCT03441399

1P50MH113840-01

Details and patient eligibility

About

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.

Full 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.

Enrollment: 120 patients

Sex: All

Ages: 21 to 64 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

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

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

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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120 participants in 3 patient groups

Escalating Incentives

Experimental group

Description:

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.

Treatment:

Other: Financial incentives

De-escalating Incentives

Experimental group

Description:

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.

Treatment:

Other: Financial incentives

Control

No Intervention group

Description:

Participants in this condition will receive usual care.