Depression
Conditions
Keywords
Medication Adherence
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.
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.
Interventions
OTHERFinancial incentives
Providing money for taking antidepressant medication
Sponsors
Columbia University
University of Pennsylvania
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
21 Years to 64 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Antidepressant adherence | Daily for first 6 weeks of study | The number of antidepressant daily doses taken during the initial six weeks of treatment |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 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). |
Countries
United States
Outcome results
None listed