OBJECTIVES: Clinical 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 acompound 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 DESIGN: Semi-structured telephone interviews with patients post intervention. METHODS:PCPs 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. RESULTS: Patients 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. CONCLUSIONS: Overall, 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.
RCT Entities:
OBJECTIVES: Clinical 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 DESIGN: Semi-structured telephone interviews with patients post intervention. METHODS: PCPs 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. RESULTS:Patients 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. CONCLUSIONS: Overall, 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.
Authors: Stephen E Kimmel; Andrea B Troxel; George Loewenstein; Colleen M Brensinger; Jane Jaskowiak; Jalpa A Doshi; Mitchell Laskin; Kevin Volpp Journal: Am Heart J Date: 2012-08 Impact factor: 4.749
Authors: Heather Schacht Reisinger; Rachel Horner Brackett; Colin D Buzza; Monica B Williams Páez; Ryan Gourley; Mark W Vander Weg; Alan J Christensen; Peter J Kaboli Journal: Health Serv Res Date: 2011-06-20 Impact factor: 3.402
Authors: David A Asch; Andrea B Troxel; Walter F Stewart; Thomas D Sequist; James B Jones; AnneMarie G Hirsch; Karen Hoffer; Jingsan Zhu; Wenli Wang; Amanda Hodlofski; Antonette B Frasch; Mark G Weiner; Darra D Finnerty; Meredith B Rosenthal; Kelsey Gangemi; Kevin G Volpp Journal: JAMA Date: 2015-11-10 Impact factor: 56.272
Authors: Ernst L Noordraven; Charlotte H Audier; Anton B P Staring; Andre I Wierdsma; Peter Blanken; Bas E A van der Hoorn; Leona Hakkaart-van Roijen; Cornelis L Mulder Journal: BMC Psychiatry Date: 2014-12-02 Impact factor: 3.630
Authors: Jan Walker; Suzanne Leveille; Gila Kriegel; Chen-Tan Lin; Stephen K Liu; Thomas H Payne; Kendall Harcourt; Zhiyong Dong; Patricia Fitzgerald; Matthew Germak; Lawrence Markson; Sara L Jackson; Hannah Shucard; Joann G Elmore; Tom Delbanco Journal: J Med Internet Res Date: 2021-11-08 Impact factor: 5.428