Effect of Escalating and Deescalating Financial Incentives vs Usual Care to Improve Antidepressant Adherence: A Pilot Randomized Clinical Trial

RCT (n=120) found escalating incentives for daily antidepressant adherence significantly improved adherence compared with a control group during the first 6 weeks of treatment, whilst the outcomes of deescalating and control groups did not significantly differ.

SPS commentary:

The two behavioral economics–based financial incentives for daily antidepressant adherence were:

  1. escalating incentives that leverage loss aversion because patients who initiate treatment face ever-greater lost opportunities if they discontinue medication use.

 

  1. deescalating incentives that leverage a tendency to overweigh present benefits by providing larger rewards to overcome initial inertia concerning treatment initiation.

JAMA Psychiatry