Are Financial Incentives Appropriate Means of Encouraging Medication Adherence Among People Living With HIV?

HIV Infections / drug therapy Humans Medication Adherence Motivation

Journal

AMA journal of ethics
ISSN: 2376-6980
Titre abrégé: AMA J Ethics
Pays: United States
ID NLM: 101649265

Informations de publication

Date de publication:
01 05 2021
Historique:
entrez: 26 5 2021
pubmed: 27 5 2021
medline: 29 7 2021
Statut: epublish

Résumé

Financial incentives have been shown to improve antiretroviral (ARV) adherence for people living with HIV, but scholars have argued that this commodifies treatment and have debated the ethics of doing so. This article summarizes research on ethical processes and factors involved in an intervention that successfully improved ARV adherence among socially vulnerable people living with HIV. Thirty qualitative interviews were conducted with intervention participants and field notes documenting organizational processes were analyzed. The protocol utilized a preexisting framework to assess the ethics of using financial incentives to motivate adherence. Financial incentives supported an ethical service provision framework by (1) establishing and strengthening client agency, (2) revising organizational protocols to prioritize adherence, and (3) promoting resource redistribution. Financial incentives, when embedded in wrap-around services, innovative client-centered organizational processes, and a justice orientation, constitute an ethical intervention requiring ethical investigation.

Sections du résumé

BACKGROUND
Financial incentives have been shown to improve antiretroviral (ARV) adherence for people living with HIV, but scholars have argued that this commodifies treatment and have debated the ethics of doing so. This article summarizes research on ethical processes and factors involved in an intervention that successfully improved ARV adherence among socially vulnerable people living with HIV.
METHODS
Thirty qualitative interviews were conducted with intervention participants and field notes documenting organizational processes were analyzed. The protocol utilized a preexisting framework to assess the ethics of using financial incentives to motivate adherence.
RESULTS
Financial incentives supported an ethical service provision framework by (1) establishing and strengthening client agency, (2) revising organizational protocols to prioritize adherence, and (3) promoting resource redistribution.
CONCLUSIONS
Financial incentives, when embedded in wrap-around services, innovative client-centered organizational processes, and a justice orientation, constitute an ethical intervention requiring ethical investigation.

Identifiants

DOI: 10.1001/amajethics.2021.394 PMID: 34038347
pubmed: 34038347
pii: amajethics.2021.394
doi: 10.1001/amajethics.2021.394
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

E394-401

Informations de copyright

© 2021 American Medical Association. All Rights Reserved.

Auteurs

Toorjo Ghose (T)

Associate professor in the School of Social Policy and Practice at the University of Pennsylvania in Philadelphia.

Virginia Shubert (V)

Co-founder and senior advisor on policy and research for Housing Works in New York City.

Sambuddha Chaudhuri (S)

Postdoctoral research fellow at the Indian Institute of Technology Bombay.

Vaty Poitevien (V)

Chief medical officer at Housing Works in New York City.

Alison Updyke (A)

Assistant professor of graduate social work at West Chester University in Pennsylvania.

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Classifications MeSH

questionsmedicales.fr › Maladies du système immunitaire › Déficits immunitaires › Infections à VIH › Are Financial Incentives Appropriate Means of...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Are Financial Incentives Appropriate Means of...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Attitude envers la santé › Adhésion et observance thérapeutiques › Acceptation des soins par les patients › Observance par le patient › Adhésion au traitement médicamenteux › Are Financial Incentives Appropriate Means of...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Personnalité › Intelligence › Intelligence émotionnelle › Motivation › Are Financial Incentives Appropriate Means of...