Use of behavioral economics to improve medication adherence in severe mental illness

Abstract

Medication nonadherence is associated with multiple negative outcomes. Financial reinforcement based on behavioral economic principles has been proposed as a potential strategy to enhance medication adherence in severe mental illness, and some studies show that small incentives significantly increase adherence to long-acting injectable treatment. After the intervention is stopped, however, adherence appears to decline. Because of the limited number of studies published so far, results should be interpreted with caution. When implementing this strategy, measures must be taken to address ethical concerns. Larger, naturalistic studies focusing on the effects of financial incentives for different treatment formulations are needed to further evaluate this adherence-enhancing strategy.