Title
The effect of individual and mixed rewards on diabetes management: A feasibility randomized controlled trial [version 3; referees: 2 approved]
Date Issued
01 January 2019
Access level
open access
Resource Type
journal article
Author(s)
Publisher(s)
F1000 Research Ltd
Abstract
Background: Incentives play a role in introducing health-related benefits, but no interventions using mixed incentives, i.e. a combination of individual and group incentives, have been tested in individuals with type 2 diabetes mellitus (T2DM). We evaluated the feasibility of implementing individual-and mixed-incentives, with and without a supportive partner, on glycated haemoglobin (HbA1c) control and weight loss among patients with T2DM. Methods: This is a feasibility, sex-stratified, single-blinded, randomized controlled study in individuals with T2DM. All participants received diabetes education and tailored goal setting for weight and glycated haemoglobin (HbA1c). Participants were randomly assigned into three arms: individual incentives (Arm 1), mixed incentives-altruism (Arm 2), and mixed incentives-cooperation (Arm 3). Participants were accompanied by a diabetes educator every other week to monitor targets, and the intervention period lasted 3 months. The primary outcome was the change in HbA1c at 3 months from baseline. Weight and change body mass index (BMI) were considered as secondary outcomes. Results: Out of 783 patients screened, a total of 54 participants, 18 per study arm, were enrolled and 44 (82%) completed the 3-month follow-up. Mean baseline HbA1c values were 8.5%, 7.9% and 8.2% in Arm 1, Arm 2, and Arm 3, respectively. At 3 months, participants in all three study arms showed reductions in HbA1c ranging from-0.9% in Arm 2 to-1.4% in Arm 1. Weight and BMI also showed reductions. Conclusions: Individual and mixed cash incentives show important reductions in HbA1c, weight and BMI in patients with type 2 diabetes mellitus after 3 months. Recruitment and uptake of the intervention were successfully accomplished demonstrating feasibility to conduct larger effectiveness studies to test individual and mixed economic incentives for diabetes management. Registration: ClinicalTrials.gov Identifier NCT02891382.
Volume
3
Language
English
OCDE Knowledge area
Endocrinología, Metabolismo (incluyendo diabetes, hormonas)
Subjects
Scopus EID
2-s2.0-85062794411
Source
Wellcome Open Research
ISSN of the container
2398-502X
Sponsor(s)
Grant information: This study was funded by the DFID/MRC/Wellcome Global Health Trials (MR/M007405/1 and 107435/Z/15/Z). AB-O
This study was funded by the DFID/MRC/Wellcome Global Health Trials (MR/M007405/1 and 107435/Z/15/Z). AB-O (103994/Z/14/Z) and JJM (074833/Z/04/Z, 205177/Z/16/Z) are supported by Wellcome Trust. JJM acknowledges receiving additional support from the Alliance for Health Policy and Systems Research (HQHSR1206660), Fogarty International Center (R21TW009982, D71TW010877), Grand Challenges Canada (0335-04), International Development Research Center Canada (106887, 108167), Inter-American Institute for Global Change Research (IAI CRN3036), Medical Research Council (MR/P008984/1, MR/P024408/1, MR/P02386X/1), National Cancer Institute (1P20CA217231), National Heart, Lung and Blood Institute (HHSN268200900033C, 5U01HL114180, 1UM1HL134590), National Institute of Mental Health (1U19MH098780), Swiss National Science Foundation (40P740-160366), and the World Diabetes Foundation (WDF15-1224).
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Our thanks to Jill Portocarrero for her work coordinating the recruitment and follow-up of participants, to the colleagues at the Department of Endocrinology, Hospital Nacional Arzobispo Loayza, for their support during the different phases of this study, and to Mariana Raffaelli for her commitment to the study.
(103994/Z/14/Z) and JJM (074833/Z/04/Z, 205177/Z/16/Z) are supported by Wellcome Trust. JJM acknowledges receiving additional support from the Alliance for Health Policy and Systems Research (HQHSR1206660), Fogarty International Center (R21TW009982, D71TW010877), Grand Challenges Canada (0335-04), International Development Research Center Canada (106887, 108167), Inter-American Institute for Global Change Research (IAI CRN3036), Medical Research Council (MR/P008984/1, MR/P024408/1, MR/P02386X/1), National Cancer Institute (1P20CA217231), National Heart, Lung and Blood Institute (HHSN268200900033C, 5U01HL114180, 1UM1HL134590), National Institute of Mental Health (1U19MH098780), Swiss National Science Foundation (40P740-160366), and the World Diabetes Foundation (WDF15-1224).
Sources of information:
Directorio de Producción Científica
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