Bilger, Marcel, Shah, Mitesh, Tan, Ngiap Chuan, Tan, Cynthia, Bundoc, Fillipinas, Bairavi, Joann, Finkelstein, Eric. 2021. Process- and Outcome-Based Financial Incentives to Improve Self-Management and Glycemic Control in People with Type 2 Diabetes in Singapore: A Randomized Controlled Trial. The Patient: Patient-Centered Outcomes Research.

RIS

@ARTICLE{Bilger2021,
title = {Process- and Outcome-Based Financial Incentives to Improve Self-Management and Glycemic Control in People with Type 2 Diabetes in Singapore: A Randomized Controlled Trial},
author = {Marcel Bilger and Mitesh Shah and Ngiap Chuan Tan and Cynthia Tan and Fillipinas Bundoc and Joann Bairavi and Eric Finkelstein},
year = {2021},
doi = {http://dx.doi.org/10.1007/s40271-020-00491-y},
url = {http://link.springer.com/content/pdf/10.1007/s40271-020-00491-y.pdf},
language = {EN},
journal = {The Patient: Patient-Centered Outcomes Research},
abstract = {Sub-optimally controlled diabetes increases risks for adverse and costly complications. Self-management including glucose monitoring, medication adherence, and exercise are key for optimal glycemic control, yet, poor self-management remains common. The main objective of the Trial to Incentivize Adherence for Diabetes (TRIAD) study was to determine the effectiveness of financial incentives in improving glycemic control among type 2 diabetes patients in Singapore, and to test whether process-based incentives tied to glucose monitoring, medication adherence, and physical activity are more effective than outcome-based incentives tied to achieving normal glucose readings. TRIAD is a randomized, controlled, multi-center superiority trial. A total of 240 participants who had at least one recent glycated hemoglobin (HbA1c) being 8.0% or more and on oral diabetes medication were recruited from two polyclinics. They were block-randomized (blocking factor: current vs. new glucometer users) into the usual care plus (UC +) arm, process-based incentive arm, and outcome-based incentive arm in a 2:3:3 ratio. The primary outcome was the mean change in HbA1c at month 6 and was linearly regressed on binary variables indicating the intervention arms, baseline HbA1c levels, a binary variable indicating titration change, and other baseline characteristics. This study suggests that both incentive types may be part of a successful self-management strategy. Process-based incentives can improve adherence to intermediary outcomes, while outcome-based incentives focus on glycemic control and are simpler to administer.},
}