The use of incentives to reinforce medication adherence

Anthony DeFulio, Kenneth Silverman

Research output: Contribution to journalReview articlepeer-review

80 Scopus citations


Objective: Poor medication adherence is a longstanding problem, and is especially pertinent for individuals with chronic conditions or diseases. Adherence to medications can improve patient outcomes and greatly reduce the cost of care. The purpose of the present review is to describe the literature on the use of incentives as applied to the problem of medication adherence. Methods: We conducted a systematic review of peer-reviewed empirical evaluations of incentives provided to patients contingent upon medication adherence. Results: This review suggests that incentive-based medication adherence interventions can be very effective, but there are few controlled studies. The studies on incentive-based medication adherence interventions most commonly feature patients taking medication for drug or alcohol dependence, HIV, or latent tuberculosis. Across studies that reported percent adherence comparisons, incentives increased adherence by a mean of 20 percentage points, but effects varied widely. Cross-study comparisons indicate a positive relationship between the value of the incentive and the impact of the intervention. Post-intervention evaluations were rare, but tended to find that adherence effects diminish after the interventions are discontinued. Conclusions: Incentive-based medication adherence interventions are promising but understudied. A significant challenge for research in this area is the development of sustainable and cost-effective long-term interventions.

Original languageEnglish (US)
Pages (from-to)S86-S94
JournalPreventive Medicine
Issue numberSUPPL.
StatePublished - Nov 1 2012


  • Applied psychology
  • Behavior
  • Behavioral economics
  • Behaviorism
  • Health behavior
  • Medical psychology
  • Medication adherence
  • Motivation
  • Patient compliance

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'The use of incentives to reinforce medication adherence'. Together they form a unique fingerprint.

Cite this