Evidence map›Paper›PMID 27624835›Full record

Trial reportImplementation science : IS2016

Can preventive care activities in general practice be sustained when financial incentives and external audit plus feedback are removed? ACCEPt-able: a cluster randomised controlled trial protocol.

Jane S Hocking, Meredith Temple-Smith, Mieke van Driel, Matthew Law, Rebecca Guy, Liliana Bulfone, Anna Wood, Nicola Low, Basil Donovan, Christopher K Fairley and 2 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Implementation science : IS, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jane S HockingMelbourne School of Population and Global Health, University of Melbourne, 3/207 Bouverie Street, Carlton, 3053, VIC, Australia. jhocking@unimelb.edu.au.
Meredith Temple-SmithDepartment of General Practice, University of Melbourne, Melbourne, Australia.
Mieke van DrielDiscipline of General Practice, University of Queensland, Brisbane, Australia.
Matthew LawKirby Institute, UNSW Australia, Sydney, Australia.
Rebecca GuyKirby Institute, UNSW Australia, Sydney, Australia.
Liliana BulfoneDeakin Health Economics, Deakin University, Melbourne, Australia.
Anna WoodMelbourne School of Population and Global Health, University of Melbourne, 3/207 Bouverie Street, Carlton, 3053, VIC, Australia.
Nicola LowUniversity of Bern, Bern, Switzerland.
Basil DonovanKirby Institute, UNSW Australia, Sydney, Australia.
Christopher K FairleyMelbourne Sexual Health Centre, Monash University, Melbourne, Australia.
John Kaldor
Jane GunnDepartment of General Practice, University of Melbourne, Melbourne, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFinancial incentives and audit plus feedback on performance are two strategies commonly used by governments to motivate general practitioners (GP) to undertake specific healthcare activities. However, in recent years, governments have reduced or removed incentive payments without evidence of the potential impact on GP behaviour and patient outcomes. This trial (known as ACCEPt-able) aims to determine whether preventive care activities in general practice are sustained when financial incentives and/or external audit plus feedback on preventive care activities are removed. The activity investigated is annual chlamydia testing for 16- to 29-year-old adults, a key preventive health strategy within this age group. METHODS/

designACCEPt-able builds on a large cluster randomised controlled trial (RCT) that evaluated a 3-year chlamydia testing intervention in general practice. GPs were provided with a support package to facilitate annual chlamydia testing of all sexually active 16- to 29-year-old patients. This package included financial incentive payments to the GP for each chlamydia test conducted and external audit plus feedback on each GP's chlamydia testing rates. ACCEPt-able is a factorial cluster RCT in which general practices are randomised to one of four groups: (i) removal of audit plus feedback-continue to receive financial incentive payments for each chlamydia test; (ii) removal of financial incentive payments-continue to receive audit plus feedback; (iii) removal of financial incentive payments and audit plus feedback; and (iv) continue financial incentive payments and audit plus feedback. The primary outcome is chlamydia testing rate measured as the proportion of sexually active 16- to 29-year-olds who have a GP consultation within a 12-month period and at least one chlamydia test. DISCUSSION: This will be the first RCT to examine the impact of removal of financial incentive payments and audit plus feedback on the chlamydia testing behaviour of GPs. This trial is particularly timely and will increase our understanding about the impact of financial incentives and audit plus feedback on GP behaviour when governments are looking for opportunities to control healthcare budgets and maximise clinical outcomes for money spent. The results of this trial will have implications for supporting preventive health measures beyond the content area of chlamydia.

trial registrationThe trial has been registered on the Australian and New Zealand Clinical Trials Registry ( ACTRN12614000595617 ).

Indexed as

AdolescentAdultAustraliaClinical ProtocolsCluster AnalysisFemaleGeneral PracticeHumansMaleMedical AuditNew ZealandPractice Patterns, Physicians'Preventive Health ServicesReimbursement, IncentiveResearch DesignSurveys and QuestionnairesAudit and feedbackCluster randomised controlled trialFinancial incentivesPreventive carePrimary care

Identifiers

PMID27624835
PMCPMC5022200

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.