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Adolygiad Systematig
Dywed yr awduron:
Dywed yr awduron:
Only one study in this review met the inclusion critieria of this evidence map (Herrmann et al., 2017):
'In summary, the present review demonstrates that there is compelling evidence that incentive-based interventions improve adherence to vaccinations, diagnostic tests and pharmacotherapies critical for the control of hepatitis, HIV and TB among individuals with SUDs [substance use disorders]. The parameters that moderate the efficacy of these interventions appear consistent with those shown to influence outcomes of CM [contingency management] for the treatment of SUDs. Incentives are a valuable tool that can be used to improve public health outcomes related to infectious disease (p. 10-11).'
In regards to the findings from the wider review, the authors state:
• Three overviews of reviews and 11 systematic reviews were identified regarding the clinical effectiveness of adherence incentives in those who require assistance to complete their tuberculosis treatment.
• Four evidence-based guidelines were identified that provided recommendations regarding the use of adherence incentives in those who require assistance completing their tuberculosis treatment.
• The reported clinical effectiveness of adherence incentives for patients with tuberculosis was mixed. There were no detrimental effects of providing incentives, but there was also no conclusive evidence pointing to a clinical benefit. The overall quality of the included reviews was moderate to high.
• The included guidelines recommended that incentives and enablers be included as a part of a patient-centred strategy for treatment and for patients with active tuberculosis or patients at high risk; however, the evidence formulating these recommendations was of low certainty or quality. Two of the included guidelines were of high methodological quality, and 2 were of lower methodological quality
Dywed yr awduron:
The authors state:
Overall, the results were neutral to positive for financial incentives and support, food incentives and support, educational incentives and support, non-cash incentives and support, and mixed supports. No studies found a detrimental clinical effect of provision of adherence incentives. The most-reported outcomes were treatment adherence and treatment completion, and the identified populations ranged from people with active or latent TB in the general public, people in low-income countries, people who use drugs, people who were homeless, and people who were incarcerated or newly released. There was significant overlap between the identified studies.
The identified overviews of reviews concluded that sustained material incentives had little to no impact on cure rates or treatment completion for active TB, and food incentives did not significantly affect cure rates, mortality, or sputum conversion. However, there were some reported benefits of incentives, as reported in some included SRs, such as benefits of financial incentives on mortality, cure rates, and treatment success. However, these benefits were not sustained in every SR or across every primary study; therefore, it is not possible to conclusively determine a benefit of adherence incentives for treatment of TB.