Posted by yxibow on January 6, 2007, at 23:08:42
In reply to Patient paid to accept neuroleptic depot injection, posted by ed_uk on January 5, 2007, at 18:47:06
> From PJOnline.........
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> Financial incentives may improve patients’ adherence to their antipsychotic medication
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> 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.
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> 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.
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> 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.
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> 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.
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> 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.”
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> 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.”
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> 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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>Financial incentives are done all the time in drug trials in the US. Just listen to your favourite AM radio station and you'll get ads for clinical trials and "payment and compensation up to..."
Its the non-payment aspect of the system I sometimes wonder the ethics -- frequently Phase II drug trials are conducted all over the world, in patients in developing parts of Eastern European, Southeast Asian, Carribean, African countries, on people who have desperation for medication and frequently little compensation.Its the Phase III trials that are conducted in areas of high Western medicine and are probably compensated in a greater fashion.
This may stray a bit from the subject but it draws some parallels I think
-- tidings
poster:yxibow
thread:719688
URL: http://www.dr-bob.org/babble/20070101/msgs/720023.html