Do Financial Incentives Increase Glucose Monitoring in Teens With T1D?

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Participants received a 3 month financial incentive, with $2 subtracted per each day of nonadherence to monitoring goals.
Participants received a 3 month financial incentive, with $2 subtracted per each day of nonadherence to monitoring goals.

HealthDay News — Financial incentives can improve adherence to glucose monitoring but not glycemic control among adolescents with type 1 diabetes, according to a study published online in JAMA Pediatrics.

Charlene A. Wong, M.D., MSHP, from Duke University in Durham, North Carolina, and colleagues randomized 90 participants (aged 14 to 20 years) with suboptimally controlled type 1 diabetes to the intervention or control arm (45 in each). The 3-month intervention consisted of a $60 monthly incentive in a virtual account, with $2 subtracted for each day of nonadherence to monitoring goals. The intervention was discontinued during a 3-month follow-up period.

The researchers found that in the incentive period, the intervention group had significantly greater adherence to glucose monitoring goals (50% vs 18.9%; adjusted difference, 27.2% [95% CI, 9.5% to 45%; P =.003]), but adherence was not significantly greater in the follow-up period (15.3% vs 8.7%; adjusted difference, 3.9% [95% CI, -2% to 9.9%; P =.2). There was no significant between-group difference in the change in HbA1c at 3 months (adjusted difference, -0.08% [95% CI, -0.69% to 0.54%; P =.8]) or 6 months (adjusted difference, 0.03% [95% CI, -0.55 to 0.6%; P =.93]).

"Among adolescents and young adults with type 1 diabetes, daily financial incentives improved glucose monitoring adherence during the incentive period but did not significantly improve glycemic control," the authors write.

Disclosures: One author is a principal at Catalyst Health, a technology and behavior change consulting firm.

Reference

  1. Wong CA, Miller VA, Murphy K, et al. Effect of financial incentives on glucose monitoring adherence and glycemic control among adolescents and young adults with type 1 diabetes [published online October 23, 2017]. JAMA Pediatr. doi:10.1001/jamapediatrics.2017.3233
  2. Mulvaney S, Lee JM. Motivating health behaviors in adolescents through behavioral economics [published online October 23, 2017]. JAMA Pediatr. doi:10.1001/jamapediatrics.2017.3464
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