ADAPT: Comparing Differing Financial Incentive Structures for Increasing Antidepressant Adherence Among Adults
Study Details
Study Description
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.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
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 Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Escalating 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. |
Other: Financial incentives
Providing money for taking antidepressant medication
|
| Experimental: De-escalating 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. |
Other: Financial incentives
Providing money for taking antidepressant medication
|
| No Intervention: Control Participants in this condition will receive usual care. |
Outcome Measures
Primary Outcome Measures
- 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
- Antidepressant adherence post-intervention [Daily between 6 and 12 weeks]
The number of antidepressant daily doses taken between 6 and 12 weeks
- 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).
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Prescribed antidepressant
-
Plan to take antidepressant as prescribed
-
Working cell phone that allows texting
-
Score on PHQ-9 ≥ 10
Exclusion Criteria:
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No antidepressant use in last 90 days
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Never been diagnosed with bipolar disorder, schizophrenia, or schizoaffective disorder
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Not currently pregnant or breastfeeding
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No other serious medical condition
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | University of Pennsylvania Health System | Philadelphia | Pennsylvania | United States | 19104 |
Sponsors and Collaborators
- University of Pennsylvania
- Columbia University
Investigators
- Principal Investigator: Steven Marcus, PhD, University of Pennsylvania
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 1P50MH113840-01