Trial reportApplied health economics and health policy2019
Using Adherence-Contingent Rebates on Chronic Disease Treatment Costs to Promote Medication Adherence: Results from a Randomized Controlled Trial.
Trial report in Applied health economics and health policy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02271269 (A Randomized Controlled Trial to Increase Glaucoma Medication Adherence Using Value Pricing), which is not on this map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
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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.
A Randomized Controlled Trial to Increase Glaucoma Medication Adherence Using Value Pricing
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Multifaceted behavioral interventions to improve topical glaucoma therapy adherence in adults.The Cochrane database of systematic reviews · 2025Pooled it
- Assessing the Impact of Behavioral Sciences Interventions on Chronic Disease Prevention and Management: A Systematic Review of Randomized Controlled Trials.International journal of environmental research and public health · 2024Pooled it
- Effect of the Support, Educate, Empower Personalized Glaucoma Coaching Program on Medication Adherence: The SEE Program Randomized Clinical Trial.JAMA ophthalmology · 2026Trial
- A Taxonomy of Behavior Change Techniques for Improving Medication Adherence in Primary Open-Angle Glaucoma.Journal of ophthalmology · 2025Review
- N-of-1 health optimization: Digital monitoring of biomarker dynamics to gamify adherence to metabolic switching.PNAS nexus · 2024Article
- Factors Affecting Glaucoma Medication Adherence and Interventions to Improve Adherence: A Narrative Review.Ophthalmology and therapy · 2023Review
- Adherence and Persistence to Medical Therapy in Glaucoma: An Overview.Ophthalmology and therapy · 2023Review
- Healthcare affordability and effects on mortality among adults with liver disease from 2004 to 2018 in the United States.Journal of hepatology · 2023Article
- Applications of Behavioral Economics to Pharmaceutical Policymaking: A Scoping Review with Implications for Best-Value Biological Medicines.Applied health economics and health policy · 2022Article
- Behavioral Economics and Tobacco Control: Current Practices and Future Opportunities.International journal of environmental research and public health · 2022Article
- Modeling Patterns of Medication Adherence in Primary Open-Angle Glaucoma.Ophthalmology scienceArticle
- Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundPoor adherence to medications is a global public health concern with substantial health and cost implications, especially for chronic conditions. In the USA, poor adherence is estimated to cause 125,000 deaths and cost $US100 billion annually. The most successful adherence-promoting strategies that have been identified so far have moderate effect, are relatively costly, and raise availability, feasibility, and/or scalability issues.
objectiveThe main objective of SIGMA (Study on Incentives for Glaucoma Medication Adherence) was to measure the effectiveness on medication adherence of a novel incentive strategy based on behavioral economics that we refer to as adherence-contingent rebates. These rebates offered patients a near-term benefit while leveraging loss aversion and regret and increasing the salience of adherence.
methodsSIGMA is a 6-month randomized, controlled, open-label, single-center superiority trial with two parallel arms. A total of 100 non-adherent glaucoma patients from the Singapore National Eye Centre were randomized into intervention (adherence-contingent rebates) and usual care (no rebates) arms in a 1:1 ratio. The primary outcome was the mean change from baseline in percentage of adherent days at Month 6. The trial registration number is NCT02271269 and a detailed study protocol has been published elsewhere.
findingsWe found that participants who were offered adherence-contingent rebates were adherent to all their medications on 73.1% of the days after 6 months, which is 12.2 percentage points (p = 0.027) higher than in those not receiving the rebates after controlling for baseline differences. This better behavioral outcome was achieved by rebates averaging 8.07 Singapore dollars ($US5.94 as of 2 November 2017) per month during the intervention period.
conclusionThis study shows that simultaneously leveraging several insights from behavioral economics can significantly improve medication adherence rates. The relatively low cost of the rebates and significant health and cost implications of medication non-adherence suggest that this strategy has the potential to cost-effectively improve health outcomes for many conditions.
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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.