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Encouraging adherence in adolescents with asthma using financial incentives: An RCT.
Keyser, Heather H De; Brinton, John T; Bothwell, Samantha; Camacho, Megan; Kempe, Allison; Szefler, Stanley J.
Afiliación
  • Keyser HH; Breathing Institute, Children's Hospital Colorado, Los Angeles, California, USA.
  • Brinton JT; Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
  • Bothwell S; Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and The Childrens Hospital, Aurora, Colorado, USA.
  • Camacho M; Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
  • Kempe A; Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
  • Szefler SJ; Breathing Institute, Children's Hospital Colorado, Los Angeles, California, USA.
Pediatr Pulmonol ; 58(10): 2823-2831, 2023 10.
Article en En | MEDLINE | ID: mdl-37449768
BACKGROUND: Medication adherence in adolescents remains a significant management challenge and innovative strategies are needed to improve medication adherence. Financial incentives have been used to improve outcomes for health behaviors among adults, but have not been well-studied among adolescents. The objective of this study was to test if a modest financial incentive improved medication adherence in adolescents with asthma compared with a control group. METHODS: Participants were randomized to either control (electronic medication monitoring [EMM] with App reminders/feedback for 4 months) or intervention (EMM + $1 per day for perfect medication adherence for 3 months [maximum $84] followed by 1 month of EMM only). A repeated measures mixed model, with a first order autoregressive correlation structure between errors, was used to test the null hypothesis for an interaction of treatment group and week. RESULTS: Fifty-two participants were enrolled, and 48 completed primary analysis. Mean adherence rates declined in both groups over time, and there was no significant difference in the change in adherence rates between the groups (F-statistic = 0.72, ndf = 15, ddf = 625, p = 0.76). Adherence rates (during the 12 weeks when incentives were given) declined from 80% to 64% in the control group, and from 90% to 58% in the incentive group. There was no significant change in the slope of decline in the incentives group in the month following payment discontinuation. CONCLUSION: A modest financial incentive did not lead to significantly different medication adherence rates in adolescents with asthma who were receiving a monitoring and reminder intervention. Further study is needed to determine viable interventions to optimize medication use in this group.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Asma / Motivación Tipo de estudio: Clinical_trials / Health_economic_evaluation / Prognostic_studies Límite: Adolescent / Adult / Humans Idioma: En Revista: Pediatr Pulmonol Asunto de la revista: PEDIATRIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Asma / Motivación Tipo de estudio: Clinical_trials / Health_economic_evaluation / Prognostic_studies Límite: Adolescent / Adult / Humans Idioma: En Revista: Pediatr Pulmonol Asunto de la revista: PEDIATRIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos