Financial Incentives Up Teen Glucose Monitoring Adherence
But no significant difference in hemoglobin A1c levels at three or six months for adolescents
TUESDAY, Oct. 24, 2017 (HealthDay News) -- Financial incentives can improve adherence to glucose monitoring but not glycemic control among adolescents with type 1 diabetes, according to a study published online Oct. 23 in JAMA Pediatrics.
Charlene A. Wong, M.D., M.S.H.P., from Duke University in Durham, North Carolina, and colleagues randomized 90 participants (aged 14 to 20 years) with suboptimally controlled type 1 diabetes to the intervention or control arm (45 in each). The three-month intervention consisted of a $60 monthly incentive in a virtual account, with $2 subtracted for each day of nonadherence to monitoring goals. The intervention was discontinued during a three-month follow-up period.
The researchers found that in the incentive period, the intervention group had significantly greater adherence to glucose monitoring goals (50 versus 18.9 percent; adjusted difference, 27.2 percent [95 percent confidence interval, 9.5 to 45 percent; P = 0.003]), but adherence was not significantly greater in the follow-up period (15.3 versus 8.7 percent; adjusted difference, 3.9 percent [95 percent confidence interval, −2 to 9.9 percent; P = 0.2). There was no significant between-group difference in the change in hemoglobin A1c at three months (adjusted difference, −0.08 percent [95 percent confidence interval, −0.69 to 0.54 percent; P = 0.8]) or six months (adjusted difference, 0.03 percent [95 percent confidence interval, −0.55 to 0.6 percent; P = 0.93]).
"Among adolescents and young adults with type 1 diabetes, daily financial incentives improved glucose monitoring adherence during the incentive period but did not significantly improve glycemic control," the authors write.
One author is a principal at Catalyst Health, a technology and behavior change consulting firm.