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Effect of Financial Incentives on Hypertension Control: A Multicenter Randomized Controlled Trial in China

Hypertension. 2022 Jul 18:101161HYPERTENSIONAHA12219568. doi: 10.1161/HYPERTENSIONAHA.122.19568. Online ahead of print.


BACKGROUND: Poorly controlled hypertension is a great challenge to global public health. Incentive approaches, based on behavioral and economic concepts, may improve patients’ adherence to treatment.

METHODS: We conducted a 2-arm randomized controlled trial to test whether financial incentives can help patients with poorly controlled hypertension in China reduce their blood pressure (BP). Participants were randomized 1:1 to the control and intervention groups. All participants received WeChat-based standard education and support for hypertension management. The intervention group received financial incentives, including process- and outcome-based incentives.

RESULTS: No statistically significant differences in BP reduction and hypertension control rates were found between the two groups from baseline to 12-month follow-up. Mean systolic BP decreased from 158.7 to 149.8 mm Hg in the intervention group and 159.7 to 149.5 mm Hg in the control group (P=0.639). Mean diastolic BP decreased from 93.7 to 86.6 mm Hg in the intervention group and 93.9 to 86.3 mm Hg in the control group (P=0.667). Hypertension control rates in the intervention and control groups were 20.8% and 15.8%, respectively (P=0.318). Medication adherence was 84.2% in the intervention group and 86.2% in the control group (P=0.705).

CONCLUSIONS: Financial incentives were effective in the short term for BP control, but a sustained effect of incentive-based BP control was not identified beyond 3 months of intervention. Future studies that focus on identifying the appropriate amount and structure of financial incentives for BP control are warranted.

REGISTRATION: URL: xxx; Unique identifier: ISRCTN13467677.

PMID:35862120 | DOI:10.1161/HYPERTENSIONAHA.122.19568

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