A spoonful of sugar...: improving adherence to tuberculosis treatment using financial incentives

Int J Tuberc Lung Dis. 2001 Jan;5(1):96-8.


Objective: To determine whether incentives increase adherence to directly observed therapy (DOT) for tuberculosis (TB) treatment.

Methods: The TB program gave a five-dollar grocery coupon for each DOT appointment kept to 55 patients who had missed at least 25% of DOT doses over a 4-week period. Treatment completion rates were compared with an historic control group of 52 patients who began treatment a year earlier, who would have been eligible for incentives but did not receive them.

Results: Incentive program patients were more likely than control patients to complete therapy within 32 weeks (OR 5.73, 95%CI 2.25-14.84) and 52 weeks (OR 7.29, 95%CI 2.45-22.73).

Conclusion: Patient incentives can increase adherence to DOT in TB programs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antitubercular Agents / administration & dosage*
  • Confidence Intervals
  • Drug Administration Schedule
  • Georgia / epidemiology
  • Humans
  • Motivation*
  • Odds Ratio
  • Patient Compliance / psychology*
  • Patient Compliance / statistics & numerical data
  • Token Economy*
  • Tuberculosis / drug therapy*
  • Urban Population


  • Antitubercular Agents