525 Participants Needed

Incentives + Reminders for Depression

SC
Overseen BySteven C Marcus, PhD
Age: 18 - 65
Sex: Any
Trial Phase: Academic
Sponsor: University of Pennsylvania
Must be taking: Antidepressants
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether personalized text messages, with or without financial rewards, can help individuals adhere to their depression medication and reduce depressive symptoms. It compares these strategies to usual care, which involves no reminders or incentives. The trial seeks individuals recently diagnosed with major depressive disorder, new to antidepressants, and who own a cell phone. As an unphased study, this trial provides a unique opportunity to explore innovative support methods for managing depression.

Will I have to stop taking my current medications?

The trial does not specify whether you need to stop taking your current medications. However, you must not have been treated with antidepressants in the past 90 days to participate.

What prior data suggests that these adherence support strategies are safe for patients with depression?

Research has shown that text messages, with or without financial rewards, are generally safe and well-received. Past studies using text messages to support health habits did not lead to serious problems. For instance, one study found that personalized text messages helped people manage their weight without major safety issues. Similarly, combining financial rewards with text messages has been used in other health areas, like managing diabetes, without reported harm.

For text messages without financial rewards, studies indicate they are safe and often welcomed by users. People generally enjoy receiving supportive messages, and no negative effects have been reported. Thus, both types of text messaging—whether they include financial rewards or not—appear safe based on past research.12345

Why are researchers excited about this trial?

Researchers are excited about these treatments because they explore innovative ways to support people with depression through the use of personalized daily text messages. Unlike traditional approaches such as medication or therapy sessions, these methods leverage technology for daily engagement, potentially offering continuous support that fits into people's everyday lives. The addition of financial incentives in one arm of the study is particularly unique, as it may motivate individuals to engage more consistently with their treatment, potentially enhancing its effectiveness. These approaches aim to make managing depression more accessible and personalized, providing new avenues for those who may not respond to or have access to conventional treatments.

What evidence suggests that this trial's treatments could be effective for depression?

This trial will compare the effects of personalized daily text messages, both with and without financial incentives, on depression management. Research has shown that personalized daily text messages with financial rewards can improve adherence to antidepressants and alleviate depression symptoms. In one study, participants who received these messages adhered better to their medication schedule. Another study found that individuals with obesity who received similar messages with financial rewards achieved better outcomes than those who did not.

For participants receiving personalized daily text messages without financial rewards, previous studies show mixed results. Some studies indicate these messages improve depression symptoms, while others report little change. However, one study found a 24% improvement in depression scores with supportive text messages. Overall, text messages may aid in managing depression, particularly when financial rewards are included.12367

Are You a Good Fit for This Trial?

This trial is for adults aged 21-64 with a clinical diagnosis of major depressive disorder, who score at least 10 on the PHQ-9, have been prescribed antidepressants by their primary care doctor, are interested in medication adherence, own a cell phone and can use an electronic pill bottle. They must be Penn Medicine primary care outpatients.

Inclusion Criteria

I am a primary care outpatient at Penn Medicine.
I own a cell phone.
My depression score is at least 10 on the PHQ-9.
See 5 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive personalized daily text reminders with or without financial incentives to improve antidepressant adherence

12 weeks
Assessments via telephone at 6 and 12 weeks

Follow-up

Participants are monitored for antidepressant adherence and depression symptoms after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Personalized Daily Text Messages with Financial Incentives
  • Personalized Daily Text Messages without Financial Incentives
Trial Overview The study tests if personalized daily text messages alone or combined with financial incentives improve adherence to antidepressant medications and reduce depression symptoms compared to usual treatment (no reminders or incentives). Adherence is tracked using a wireless pill bottle and health records.
How Is the Trial Designed?
3Treatment groups
Experimental Treatment
Active Control
Group I: Arm 2Experimental Treatment2 Interventions
Group II: Arm 1Experimental Treatment1 Intervention
Group III: Arm 3Active Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Pennsylvania

Lead Sponsor

Trials
2,118
Recruited
45,270,000+

Published Research Related to This Trial

A study involving 1,217 participants found that personalized feedback significantly improved smoking cessation rates, with continuous abstinence at 3 and 12 months being twice as high in the feedback group compared to others.
In contrast, while a financial incentive increased the use of self-help materials, it did not improve cessation rates and was linked to higher relapse rates among those who quit.
Evaluation of intrinsic and extrinsic motivation interventions with a self-help smoking cessation program.Curry, SJ., Wagner, EH., Grothaus, LC.[2019]
Digital mental health apps have been shown to effectively reduce symptoms of anxiety and depression, with a small-to-medium overall effect size based on a meta-analysis of 25 studies involving 4159 participants.
Apps that included more engagement features tended to have larger effects on clinical outcomes, but surprisingly, there was a negative correlation between the use of persuasive system design features and user engagement, suggesting that simply adding features may not guarantee higher completion rates.
Smartphone apps for depression and anxiety: a systematic review and meta-analysis of techniques to increase engagement.Wu, A., Scult, MA., Barnes, ED., et al.[2023]
Nudges are simple and cost-effective interventions that can help reduce behavioral risk factors for depression, such as low physical activity, poor coping strategies, and weak social connections.
By leveraging cognitive biases, nudges can encourage healthier behaviors, making them a practical alternative to more expensive preventive therapies like problem-solving therapy.
"Nudges" to Prevent Behavioral Risk Factors Associated With Major Depressive Disorder.Woodend, A., Schölmerich, V., Denktaş, S.[2018]

Citations

Antidepressant Adherence for Depressed Adults in Primary ...We will examine whether personalized daily text messages with and without financial incentives improves antidepressant adherence and depression symptoms.
Incentives + Reminders for DepressionWe will examine whether personalized daily text messages with and without financial incentives improves anti-depressant adherence and depression symptoms as ...
A Text Messaging Intervention With Financial Incentive for ...Participants who responded to TMs for the most consecutive days were eligible for a financial reward biweekly via lottery. All participants received prompts to ...
Antidepressant Adherence for Depressed Adults in Primary CareWe will examine whether personalized daily text messages with and without financial incentives improves antidepressant adherence and depression symptoms.
Text Messages With Financial Incentives for Men With ObesityAmong men with obesity, an intervention with text messaging with financial incentive significantly improved weight loss compared with a control group, whereas ...
Personalized Patient Data and Behavioral Nudges to ...Text messages can be augmented with chatbots that can facilitate interactive conversations with patients and/or brief behavioral interventions ...
Randomized controlled study using text messages to help ...We conducted a randomized controlled trial of tailored text messages with newly enrolled Medicaid managed care beneficiaries.
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