PT  - JOURNAL ARTICLE
AU  - Stefan Priebe
AU  - Julia Sinclair
AU  - Alexandra Burton
AU  - Stamatina Marougka
AU  - John Larsen
AU  - Mike Firn
AU  - Richard Ashcroft
TI  - Acceptability of offering financial incentives to achieve medication adherence in patients with severe mental illness: a focus group study
AID  - 10.1136/jme.2009.035071
DP  - 2010 Aug 01
TA  - Journal of Medical Ethics
PG  - 463--468
VI  - 36
IP  - 8
4099  - http://jme.bmj.com/content/36/8/463.short
4100  - http://jme.bmj.com/content/36/8/463.full
SO  - J Med Ethics2010 Aug 01; 36
AB  - Background Offering financial incentives to achieve medication adherence in patients with severe mental illness is controversial.Aims To explore the views of different stakeholders on the ethical acceptability of the practice.Method Focus group study consisting of 25 groups with different stakeholders.Results Eleven themes dominated the discussions and fell into four categories: (1) ‘wider concerns’, including the value of medication, source of funding, how patients would use the money, and a presumed government agenda behind the idea; (2) ‘problems requiring clear policies’, comprising of practicalities and assurance that incentives are only one part of a tool kit; (3) ‘challenges for research and experience’, including effectiveness, the possibility of perverse incentives, and impact on the therapeutic relationship; (4) ‘inherent dilemmas’ around fairness and potential coercion.Conclusions The use of financial incentives is likely to raise similar concerns in most stakeholders, only some of which can be addressed by empirical research and clear policies.