Incentives and Glucose Adherence in Diabetes

University of Iowa

Status: Completed

Conditions: Diabetes in Pregnancy

Treatments: Behavioral: Positive incentive; Behavioral: Loss aversion

Study type: Interventional

Funder types: Other

Identifiers

NCT03338829

201603724

Details and patient eligibility

About

Diabetes in pregnancy carries significant pregnancy specific risks and requires frequent glucose monitoring to reduce these risks. This project compares the effect of two incentive schemes on adherence rates of glucose testing in pregnancy.

Full description

Diabetes in pregnancy is associated with increased risks of maternal and fetal complications and can be challenging to manage due to increasing insulin requirements with advancing gestational age. Based on standard of care guidelines, patients with diabetes check their blood glucose at least 4 times per day. Optimal management requires frequent glucose self-monitoring and active management of abnormal blood sugars and medications by clinicians. Poorly controlled diabetes has both significant maternal and neonatal consequences: Improving test adherence could benefit both the pregnant woman and her fetus. In this study, we propose to test the effect of two incentive schemes on rates of glucose monitoring on pregnant women with diabetes requiring medication.

Pregnant women with diabetes requiring medication are invited to participate if they meet specific inclusion criteria (<29 weeks) and followed in our outpatient clinic. Participants are randomized into one of three groups:

1. control group - receive compensation at time of enrollment,
2. positive incentive group - receive compensation per test completed
3. loss aversion group - receive between a range of compensation depending on their overall level of adherence.

Primary outcome of the study is frequency of prescribed glucose testing in pregnancy

Enrollment: 130 patients

Sex: Female

Ages: 18 to 50 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• pregnant women with insulin dependent diabetes prior to 29 weeks gestation.

Exclusion criteria

• incarcerated, not English speaking

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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130 participants in 3 patient groups

Control

No Intervention group

Description:

The control arm will receive compensation at time of enrollment for agreeing to participate.

Positive Incentive

Experimental group

Description:

The positive incentive arm will receive compensation per prescribed test, payable every month based on testing adherence.

Treatment:

Behavioral: Positive incentive

Loss Aversion

Experimental group

Description:

The loss aversion arm will have compensation deposited into a University of Iowa Women's Health account. The participant will then "lose" compensation depending on actual adherence to recommended testing

Treatment:

Behavioral: Loss aversion