Although antidepressant medications are efficacious for depression,1 nonadherence frequently undermines their effectiveness.2 Antidepressants have a delayed onset and therefore do not offer prompt symptom relief that would support adherence.3 It is unknown whether financial incentives, which encourage adherence to some4 but not other5 health behaviors, improve antidepressant adherence for depression. This randomized clinical trial (ClinicalTrials.gov Identifier: NCT03441399) compared 2 behavioral economics–based financial incentives for daily antidepressant adherence: (1) escalating incentives that leverage loss aversion because patients who initiate treatment face ever-greater lost opportunities if they discontinue medication use and (2) deescalating incentives that leverage a tendency to overweigh present benefits by providing larger rewards to overcome initial inertia concerning treatment initiation.
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Marcus SC, Reilly ME, Zentgraf K, Volpp KG, Olfson M. Effect of Escalating and Deescalating Financial Incentives vs Usual Care to Improve Antidepressant Adherence: A Pilot Randomized Clinical Trial. JAMA Psychiatry. 2021;78(2):222–224. doi:10.1001/jamapsychiatry.2020.3000
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