Willingness of people who inject drugs to participate in a randomised controlled trial involving financial incentives to initiate hepatitis C treatment

Alison D Marshall; Anna Conway; Evan B Cunningham; Heather Valerio; David Silk; Maryam Alavi; Alexandra Wade; Thao Lam; Krista Zohrab; Adrian Dunlop; Chris Connelly; Michael Christmass; Victoria Cock; Carina Burns; Charles Henderson; Virginia Wiseman; Gregory J Dore; Jason Grebely

doi:10.1016/j.drugalcdep.2022.109438

Willingness of people who inject drugs to participate in a randomised controlled trial involving financial incentives to initiate hepatitis C treatment

Drug Alcohol Depend. 2022 Jun 1:235:109438. doi: 10.1016/j.drugalcdep.2022.109438. Epub 2022 Apr 4.

Authors

Alison D Marshall¹, Anna Conway², Evan B Cunningham³, Heather Valerio⁴, David Silk⁵, Maryam Alavi⁶, Alexandra Wade⁷, Thao Lam⁸, Krista Zohrab⁹, Adrian Dunlop¹⁰, Chris Connelly¹¹, Michael Christmass¹², Victoria Cock¹³, Carina Burns¹⁴, Charles Henderson¹⁵, Virginia Wiseman¹⁶, Gregory J Dore¹⁷, Jason Grebely¹⁸

Affiliations

¹ The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia; Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2052, Australia. Electronic address: [email protected].
² The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia; Centre for Social Research in Health, UNSW Sydney, Sydney, NSW 2052, Australia. Electronic address: [email protected].
³ The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia. Electronic address: [email protected].
⁴ The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia. Electronic address: [email protected].
⁵ The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia. Electronic address: [email protected].
⁶ The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia. Electronic address: [email protected].
⁷ Drug and Alcohol Clinical Services, Mid North Coast Local Health District, Kempsey, NSW 2440, Australia. Electronic address: [email protected].
⁸ Drug and Alcohol Clinical Services, Western Sydney Local Health District, Sydney, NSW 2770, Australia. Electronic address: [email protected].
⁹ Lismore Liver Clinic, Mid North Coast Local Health District, Lismore, NSW 2480, Australia. Electronic address: [email protected].
¹⁰ Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, NSW 2302, Australia. Electronic address: [email protected].
¹¹ North Metro Community Alcohol & Drug Service, Joondalup, WA 6027, Australia. Electronic address: [email protected].
¹² National Drug Research Institute, Curtin University, Perth, WA 6102, Australia; Next Step Community Alcohol and Drug Services, East Perth, WA 6004, Australia. Electronic address: [email protected].
¹³ Drug and Alcohol Services South Australia (DASSA), Adelaide, SA 5069, Australia. Electronic address: [email protected].
¹⁴ Drug and Alcohol Clinical Services, South Western Sydney Local Health District, NSW 2170, Australia. Electronic address: [email protected].
¹⁵ NSW Users and AIDS Association, Sydney, NSW 2010, Australia. Electronic address: [email protected].
¹⁶ The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia; London School of Hygiene and Tropical Medicine, University of London, London, WC1E 7HT, United Kingdom. Electronic address: [email protected].
¹⁷ The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia. Electronic address: [email protected].
¹⁸ The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia. Electronic address: [email protected].

PMID: 35430521
DOI: 10.1016/j.drugalcdep.2022.109438

Abstract

Background: Evidence regarding the acceptability of contingency management is limited. We investigated the willingness of people who inject drugs to participate in a randomised controlled trial (RCT) involving financial incentives to initiate HCV treatment.

Methods: ETHOS Engage is an observational cohort study of people with a history of injecting drug use who either injected in the past six months or receive opioid agonist therapy (OAT) in Australia. We assessed willingness to participate in a RCT with financial incentives and factors associated with preference for entire incentive ($60) at first clinic visit versus delayed incentive with logistic regression.

Results: 93% (593/635) of eligible participants agreed to participate in an RCT with financial incentives of which 24% were Aboriginal or Torres Strait Islander, 84% had completed secondary school, and 59% injected drugs in the prior month. Willingness to participate in an RCT increased by amount offered: unspecified (72%), $20 (75%), $60 (80%), and $100 (85%). The preferred incentive distribution method over three clinical visits was entire incentive at first clinical visit (32%). Among those with a preferred distribution method (n = 369), factors associated with entire incentive at first clinic visit were being Aboriginal or Torres Strait Islander (aOR 1.75; 95% CI 1.05-2.94), completion of secondary school (aOR 0.46; 95% CI 0.26-0.83) and mainly injected heroin in month prior (aOR 1.82; 95% CI 1.03-3.20).

Conclusion: Most participants were willing to participate in an RCT involving financial incentives to initiate treatment but differed regarding distribution. Study findings inform implementation of incentives in clinical practice.

Keywords: Acceptability; Contingency management; Hepatitis C; RCT; Treatment.

Publication types

Observational Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Cohort Studies
Drug Users*
Hepatitis C* / drug therapy
Humans
Motivation
Substance-Related Disorders*