Evidence map›Paper›PMID 28817301›Full record

Trial reportThe American journal of managed care2017

Patients' views of a behavioral intervention including financial incentives.

Judy A Shea, Aderinola Adejare, Kevin G Volpp, Andrea B Troxel, Darra Finnerty, Karen Hoffer, Thomas Isaac, Meredith Rosenthal, Thomas D Sequist, David A Asch

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC
In one paragraph

Trial report in The American journal of managed care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Moving the Dial on Heart Failure Patient Adherence Rates.Patient preference and adherence · 2020
    Review
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

10 authors.

Judy A SheaPerelman School of Medicine at the University of Pennsylvania, 1229 Blockley Hall, 423 Guardian Dr, Philadelphia, PA 19104. E-mail: sheaja@mail.med.upenn.edu.
Aderinola Adejare
Kevin G Volpp
Andrea B Troxel
Darra Finnerty
Karen Hoffer
Thomas Isaac
Meredith Rosenthal
Thomas D Sequist
David A Asch

Funding

The Penn Roybal Center on Behavioral Economics and Health: Solving for Scale and Impact with Design Thinking, Digital Platforms, and Dynamic AdaptationP30AG034546 · NIA · UNIVERSITY OF PENNSYLVANIA · PI Alison Meredith Buttenheim · 2009 to 2026
$10.6M
NIA NIH HHS P30 AG034546
6 · The paper itself

Abstract

objectivesClinical trials are increasingly testing the effectiveness of paying patients' financial incentives for achieving desired clinical outcomes. Some researchers and providers are concerned that patient financial incentives will harm the doctor-patient relationship. How patients feel about these approaches, and these trials, is largely unknown. This study examined patients' perceptions of a compound behavioral and financial incentive intervention used in a large multicenter trial to lower low-density lipoprotein cholesterol (LDL-C), including their perceptions of benefits and challenges and the study's effect on patients' relationship with their primary care physicians (PCPs). STUDY

designSemi-structured telephone interviews with patients post intervention.

methodsPCPs from 3 primary care practices in the northeastern United States were randomized to 1 of 4 arms: physician financial incentives, patient financial incentives, shared incentives between physicians and patients, and a control arm. Within each arm, 10 high, 10 medium, and 10 low performers in LDL-C reduction were interviewed. Interviews targeted reasons for enrolling in the study, the specific intervention elements that helped them reach the goal (incentives, engagement, monitoring), challenges faced in reducing cholesterol, and the impact of study participation on their relationship with their PCP.

resultsPatients reported positive experiences with the study: 65% described personal changes to improve health and 61% reported increased awareness. Views about financial incentives varied: 71% clearly found them motivating and 36% claimed they made no difference. Patients noted that changing lifestyle (36%) and diet (65%) was difficult. Patients who substantially lowered their LDL-C revealed themes similar to those who did not.

conclusionsOverall, behavioral interventions with financial incentives appear to be socially acceptable to patients who participate in them. Both adherence monitoring and financial incentives were well received, with little effect on the physician-patient relationship.

Indexed as

Attitude to HealthMotivationCholesterol, LDLFemaleHumansHypercholesterolemiaHypolipidemic AgentsInterviews as TopicMaleMiddle AgedPhysician-Patient RelationsReimbursement, IncentiveRisk Reduction BehaviorCholesterol, LDLHypolipidemic Agents

Identifiers

PMID28817301
PMCPMC6171344

What OpenQuestion holds

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Registered trials

None linked

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.