Cochrane researchers conducted a review of the effects of material
(economic) incentives or enablers on the adherence and outcomes of
patients being tested or treated for latent or active tuberculosis (TB).
After searching up to 5 June 2015 for relevant trials, they included 12
randomized controlled trials in this Cochrane review.
What are material incentives and enablers and how might they improve
Material incentives and enablers are economic interventions which may be
given to patients to reward healthy behaviour (incentives) or remove
economic barriers to accessing healthcare (enablers). Incentives and
enablers may be given directly as cash or vouchers, or indirectly in the
provision of a service for which the patient might otherwise have to pay
(like transport to a health facility).
What the research says
Material incentives and enablers may have little or no effect in
improving the outcomes of patients on treatment for active TB (low
quality evidence), but further trials of alternative incentives and
enablers are needed.
Material incentives and enablers may have some effects on completion of
prophylaxis for latent TB in some circumstances but trial results were
mixed, with one trial showing a large effect, and two trials showing no
effect (low quality evidence).
One-off material incentives and enablers probably improve rates of
return to a single clinic appointment for patients starting or
continuing prophylaxis for TB (moderate quality evidence) and may
improve the rate of return to the clinic for the reading of diagnostic
tests for TB (low quality evidence).
Thus although material incentives and enablers may improve some
patients' attendance at the clinic in the short term, more research is
needed to determine if they have an important positive effect in
patients on long term treatment for TB.
Lutge, E.E.; Wiysonge, C.S.; Knight, S.E.; Sinclair, D.; Volmink, J. Incentives and enablers to improve adherence in tuberculosis. Cochrane Database of Systematic Reviews (2015) : [DOI: 10.1002/14651858.CD007952.pub3]
Incentives and enablers to improve adherence in tuberculosis