Telephone delivered Incentives for Encouraging adherence to Supervised methadone consumption: development and feasibility study for an RCT of clinical and cost effectiveness.
Funded by NIHR.
Most people treated for heroin addiction are prescribed methadone which enables them to stop heroin use safely avoiding withdrawal. People starting methadone take a daily dose under a pharmacist’s supervision to prevent overdose. If a patient misses their daily methadone, they will experience opiate withdrawal and cravings which make them more likely to use heroin. If a patient misses their methadone for three days in a row, they will lose their tolerance to the drug and risk overdose. Unfortunately, many patients do miss their doses. Non-adherence with medication is associated with non-attendance at medical and psychosocial appointments. There is an urgent need to develop effective interventions for medication adherence. Research shows that contingency management interventions (delivery of small financial incentives) can improve medication adherence.
While contingency management (CM) requires time and organisational systems which can be challenging in pharmacies dispensing to high volume of patients, effective methods to improve adherence need to be maintained for as long as the treatment is needed, requiring interventions that can be integrated into the care system in a cost-effective manner. We believe CM delivered by technology can encourage medication adherence among individuals receiving OST and be resource light and cost effective.