Trial reportThe American journal of managed care2015
A randomized controlled trial of negative co-payments: the CHORD trial.
Trial report in The American journal of managed care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Association of Economic Policies With Hypertension Management and Control: A Systematic Review.JAMA health forum · 2024Pooled it
- Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes.The Cochrane database of systematic reviews · 2023Pooled it
- How to make value-based health insurance designs more effective? A systematic review and meta-analysis.The European journal of health economics : HEPAC : health economics in prevention and care · 2019Pooled it
- Effect of Financial Incentives for Process, Outcomes, or Both on Cholesterol Level Change: A Randomized Clinical Trial.JAMA network open · 2021Trial
- Pharmacy Subscription Program and Medication Refills, Days' Supply, and Out-of-Pocket Costs.JAMA network open · 2025Article
- Study design of BETTER-BP: Behavioral economics trial to enhance regulation of blood pressure.International journal of cardiology. Cardiovascular risk and prevention · 2022Article
- Medication Adherence and Blood Pressure Control: A Scientific Statement From the American Heart Association.Hypertension (Dallas, Tex. : 1979) · 2022Article
- Student perceptions of a teaching electronic medical record in Health Administration education.The Journal of health administration education · 2022Article
- The Role of Behavioral Economics in Improving Cardiovascular Health Behaviors and Outcomes.Current cardiology reports · 2021Review
- Commentary on "Do physician incentives increase patient medication adherence?"Health services research · 2020Article
- Behavioral Economic Insights to Improve Medication Adherence in Adults with Chronic Conditions: A Scoping Review.The patient · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
objectivesValue-based insurance designs are being widely used. We undertook this study to examine whether a financial incentive that lowered co-payments for blood pressure medications below $0 improved blood pressure control among patients with poorly controlled hypertension. STUDY
designRandomized controlled trial.
methodsParticipants from 3 Pennsylvania hospitals (n = 337) were randomly assigned to: a) be paid $8 per medication per month for filling blood pressure prescriptions, b) a computerized behavioral intervention (CBI), c) both payment and CBI, or d) usual care. The primary outcome was change in blood pressure between baseline and 12 months post enrollment. We also measured adherence using the medication possession ratio in a subset of participants.
resultsThere were no significant interactions between the incentive and the CBI interventions. There were no significant changes in medication possession ratio in the treatment group. Blood pressure decreased among all participants, but to a similar degree between the financial incentive and control groups. Systolic blood pressure (SBP) dropped 13.7 mm Hg for the incentive group versus 10.0 mm Hg for the control group (difference = –3.7; 95% CI, –9.0 to 1.6; P = .17). The proportion of patients with blood pressure under control 12 months post enrollment was 35.6% of the incentive group versus 27.7% of the control group (odds ratio, 1.4; 95% CI, 0.8-2.5; P = .19). Diabetics in the incentive group had an average drop in SBP of 12.7 mm Hg between baseline and 12 months compared with 4.0 mm Hg in the control group (P = .02). Patients in the incentive group without diabetes experienced average SBP reductions of 15.0 mm Hg, compared with 16.3 mm Hg for control group nondiabetics (P = .71).
conclusionsAmong patients with poorly controlled blood pressure, financial incentives—as implemented in this trial—did not improve blood pressure control or adherence except among patients with diabetes.
Indexed as
Identifiers
26625506PMC6171502W2411196887What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.