Incentives and Glucose Adherence in Diabetes
| Status: | Recruiting |
|---|---|
| Conditions: | Diabetes |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 12 - 50 |
| Updated: | 6/20/2018 |
| Start Date: | May 5, 2016 |
| End Date: | March 2020 |
| Contact: | Sarah Wernimont, MD, PhD |
| Email: | sarah-wernimont@uiowa.edu |
Incentive Models on Testing Adherence for Women With Diabetes During Pregnancy
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.
glucose monitoring to reduce these risks. This project compares the effect of two incentive
schemes on adherence rates of glucose testing in pregnancy.
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 (<28 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
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 (<28 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
Inclusion Criteria:
- pregnant women with insulin dependent diabetes prior to 28 weeks gestation.
Exclusion Criteria:
- incarcerated, not English speaking
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