Featured Research

from universities, journals, and other organizations

Small cash incentives dramatically improve hepatitis B vaccination rates among injecting drug users

Date:
April 8, 2014
Source:
The Lancet
Summary:
Small financial incentives, totaling as little as 30, can dramatically increase the likelihood of people who inject drugs completing a course of hepatitis B virus vaccination, according to new research. Researchers in the UK found that people undergoing treatment for heroin addiction who received a maximum total of 30 supermarket vouchers in equal or graduated installments in return for full compliance with a regimen of three HBV vaccine injections were at least 12 times as likely to complete the course within 28 days compared to those not receiving a financial incentive.

Small financial incentives, totalling as little as 30, can dramatically increase the likelihood of people who inject drugs completing a course of hepatitis B virus (HBV) vaccination, according to new research published in The Lancet.

Researchers in the UK found that people undergoing treatment for heroin addiction who received a maximum total of 30 supermarket vouchers in equal or graduated installments in return for full compliance with a regimen of three HBV vaccine injections were at least 12 times as likely to complete the course within 28 days compared to those not receiving a financial incentive (45% for equal payment installments and 49% for graduated payment installments vs 9% for no payment incentive).

The study was led by Professor John Strang from the National Addiction Centre at King's College London, UK, working in close collaboration with senior colleagues at Imperial College London and University College London (UCL), in the UK.

"That monetary incentives increase compliance is unremarkable, but the size of the increase we observed was striking", says Professor Strang. "Injecting drug users are at high risk of infection and transmission of hepatitis B. This is a potentially life-saving vaccine, and increasing its uptake among this group has important benefits to public health, as well as to the individual."

HBV affects about 22% of injecting drug users in the UK, and much higher proportions in other countries. Medication can slow the spread of HBV, but there is no completely effective cure. It is estimated that 15-25% of people with untreated chronic HBV die of liver disease [1]. A highly effective vaccine exists, but the rate of vaccination uptake is poor. Financial incentive-based public health strategies for treating addiction have gained popularity in the USA in recent years, but such incentive schemes are less common in the UK.

The new study enrolled 210 people receiving opioid substitution therapy from 12 National Health Service drug treatment services across the UK. Services were randomly assigned to different voucher schedules, so that patients received either HBV vaccination without incentive (treatment as usual), fixed value contingency management (10 voucher at each of three vaccinations), or escalating value contingency management (5 voucher at first vaccination visit, 10 voucher at second visit, and 15 voucher at third visit).

The researchers compared the effectiveness of these three approaches in achieving completion of vaccination. In the treatment as usual group, only six (9%) of 67 participants completed all scheduled vaccinations, compared with 35 (45%) of 78 participants in the fixed reward group, and 32 (49%) of 65 participants in the escalating reward group.

Additionally, the authors noted that most participants (at least 80%) receiving financial incentives attended appointments on time, ensuring a more efficient use of resources.

According to Professor Strang, "Our research finds that offering financial incentives improves people's completion of HBV vaccination, and can be achieved in routine clinical practice. However, even with these improvements, only about half the participants completed the vaccination schedule in the contingency management groups: more work is needed to refine the reward scheme to increase further the uptake and completion of vaccination."

Writing in a linked Comment, A Thomas McLellan, Director of the Treatment Research Institute in Philadelphia, USA, says, "Health care policy makers might be wise to consider traditional market forces when designing and delivering prevention strategies. The findings from Weaver and colleagues' study suggest that contingent financial incentives might be as or more important in the disease prevention marketplace as they are in commercial markets."


Story Source:

The above story is based on materials provided by The Lancet. Note: Materials may be edited for content and length.


Journal Reference:

  1. John Strang et al. Use of contingency management incentives to improve completion of hepatitis B vaccination in people undergoing treatment for heroin dependence: a cluster randomised trial. The Lancet, April 2014 DOI: 10.1016/S0140-6736(14)60196-3

Cite This Page:

The Lancet. "Small cash incentives dramatically improve hepatitis B vaccination rates among injecting drug users." ScienceDaily. ScienceDaily, 8 April 2014. <www.sciencedaily.com/releases/2014/04/140408213549.htm>.
The Lancet. (2014, April 8). Small cash incentives dramatically improve hepatitis B vaccination rates among injecting drug users. ScienceDaily. Retrieved October 1, 2014 from www.sciencedaily.com/releases/2014/04/140408213549.htm
The Lancet. "Small cash incentives dramatically improve hepatitis B vaccination rates among injecting drug users." ScienceDaily. www.sciencedaily.com/releases/2014/04/140408213549.htm (accessed October 1, 2014).

Share This



More Health & Medicine News

Wednesday, October 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Pregnancy Spacing Could Have Big Impact On Autism Risks

Pregnancy Spacing Could Have Big Impact On Autism Risks

Newsy (Oct. 1, 2014) A new study says children born less than one year and more than five years after a sibling can have an increased risk for autism. Video provided by Newsy
Powered by NewsLook.com
Robotic Hair Restoration

Robotic Hair Restoration

Ivanhoe (Oct. 1, 2014) A new robotic procedure is changing the way we transplant hair. The ARTAS robot leaves no linear scarring and provides more natural results. Video provided by Ivanhoe
Powered by NewsLook.com
Insertable Cardiac Monitor

Insertable Cardiac Monitor

Ivanhoe (Oct. 1, 2014) A heart monitor the size of a paperclip that can save your life. The “Reveal Linq” allows a doctor to monitor patients with A-Fib on a continuous basis for up to 3 years! Video provided by Ivanhoe
Powered by NewsLook.com
Attacking Superbugs

Attacking Superbugs

Ivanhoe (Oct. 1, 2014) Two weapons hospitals can use to attack superbugs. Scientists in Ireland created a new gel resistant to superbugs, and a robot that can disinfect a room in minutes. Video provided by Ivanhoe
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins