A digital intervention using daily financial incentives to increase medication adherence in severe mental illness: Single-arm longitudinal pilot study

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• dc.contributor.author Guinart, Dani
• dc.contributor.author Sobolev, Michael
• dc.contributor.author Patil, Bhagyashree
• dc.contributor.author Walsh, Megan
• dc.contributor.author Kane, John M.
• dc.date.accessioned 2023-01-31T07:14:57Z
• dc.date.available 2023-01-31T07:14:57Z
• dc.date.issued 2022
• dc.description.abstract Background: Medication nonadherence is prevalent in severe mental illness and is associated with multiple negative outcomes. Mobile technology and financial incentives show promise to improve medication adherence; however, studies in mental health, especially with oral medications, are lacking. Objective: The aim of this paper is to assess the feasibility and effectiveness of offering financial incentives through a mobile app based on behavioral economics principles to improve medication adherence in severe mental illness. Methods: A 10-week, single-arm longitudinal pilot study was conducted. Patients earned rewards in the context of app-based adherence incentives. The reward was split into biweekly payments made in increments of US $15, minus any US $2 per day penalties for missed check-ins. Time-varying effect modeling was used to summarize the patients' response during the study. Results: A total of 25 patients were enrolled in this pilot study, of which 72% (n=18) were female, and 48% (n=12) were of a White racial background. Median age was 24 (Q1-Q3: 20.5-30) years. Participants were more frequently diagnosed with schizophrenia and related disorders (n=9, 36%), followed by major depressive disorder (n=8, 32%). App engagement and medication adherence in the first 2 weeks were higher than in the last 8 weeks of the study. At study endpoint, app engagement remained high (n=24, Z=-3.17; P<.001), but medication adherence was not different from baseline (n=24, Z=-0.59; P=.28). Conclusions: Financial incentives were effectively delivered using an app and led to high engagement throughout the study and a significantly increased medication adherence for 2 weeks. Leveraging behavioral economics and mobile health technology can increase medication adherence in the short term. Trial registration: ClinicalTrials.gov NCT04191876; https://clinicaltrials.gov/ct2/show/NCT04191876.
• dc.format.mimetype application/pdf
• dc.identifier.citation Guinart D, Sobolev M, Patil B, Walsh M, Kane JM. A digital intervention using daily financial incentives to increase medication adherence in severe mental illness: Single-arm longitudinal pilot study. JMIR Ment Health. 2022 Oct 12;9(10):e37184. DOI: 10.2196/37184
• dc.identifier.doi http://dx.doi.org/10.2196/37184
• dc.identifier.issn 2368-7959
• dc.identifier.uri http://hdl.handle.net/10230/55494
• dc.language.iso eng
• dc.publisher JMIR Publications Inc.
• dc.relation.ispartof JMIR Ment Health. 2022 Oct 12;9(10):e37184
• dc.rights © Daniel Guinart, Michael Sobolev, Bhagyashree Patil, Megan Walsh, John M Kane. Originally published in JMIR Mental Health (https://mental.jmir.org), 12.10.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on https://mental.jmir.org/, as well as this copyright and license information must be included.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Adherence
• dc.subject.keyword Antipsychotic
• dc.subject.keyword Digital
• dc.subject.keyword Financial incentives
• dc.subject.keyword mHealth
• dc.subject.keyword Mobile health
• dc.title A digital intervention using daily financial incentives to increase medication adherence in severe mental illness: Single-arm longitudinal pilot study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion