Miranda J Jaime, Lazo-Porras María, Bernabe-Ortiz Antonio, Pesantes M Amalia, Diez-Canseco Francisco, Cornejo Socorro Del Pilar, Trujillo Antonio J
CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
Wellcome Open Res. 2019 Feb 5;3:139. doi: 10.12688/wellcomeopenres.14824.3. eCollection 2018.
Incentives play a role in introducing health-related benefits, but no interventions using mixed incentives, i.e. a combination of individual and group incentives, have been tested in individuals with type 2 diabetes mellitus (T2DM). We evaluated the feasibility of implementing individual- and mixed-incentives, with and without a supportive partner, on glycated haemoglobin (HbA1c) control and weight loss among patients with T2DM. This is a feasibility, sex-stratified, single-blinded, randomized controlled study in individuals with T2DM. All participants received diabetes education and tailored goal setting for weight and glycated haemoglobin (HbA1c). Participants were randomly assigned into three arms: individual incentives (Arm 1), mixed incentives-altruism (Arm 2), and mixed incentives-cooperation (Arm 3). Participants were accompanied by a diabetes educator every other week to monitor targets, and the intervention period lasted 3 months. The primary outcome was the change in HbA1c at 3 months from baseline. Weight and change body mass index (BMI) were considered as secondary outcomes. Out of 783 patients screened, a total of 54 participants, 18 per study arm, were enrolled and 44 (82%) completed the 3-month follow-up. Mean baseline HbA1c values were 8.5%, 7.9% and 8.2% in Arm 1, Arm 2, and Arm 3, respectively. At 3 months, participants in all three study arms showed reductions in HbA1c ranging from -0.9% in Arm 2 to -1.4% in Arm 1. Weight and BMI also showed reductions. Individual and mixed cash incentives show important reductions in HbA1c, weight and BMI in patients with type 2 diabetes mellitus after 3 months. Recruitment and uptake of the intervention were successfully accomplished demonstrating feasibility to conduct larger effectiveness studies to test individual and mixed economic incentives for diabetes management. Registration: ClinicalTrials.gov Identifier NCT02891382.
激励措施在引入与健康相关的益处方面发挥着作用，但尚未有针对2型糖尿病（T2DM）患者采用混合激励措施（即个人激励与团体激励相结合）的干预措施进行过测试。我们评估了在有或没有支持性伴侣的情况下，实施个人激励和混合激励措施对T2DM患者糖化血红蛋白（HbA1c）控制和体重减轻的可行性。这是一项针对T2DM患者的可行性、按性别分层、单盲、随机对照研究。所有参与者均接受糖尿病教育，并针对体重和糖化血红蛋白（HbA1c）制定个性化目标设定。参与者被随机分为三组：个人激励组（第1组）、混合激励-利他组（第2组）和混合激励-合作组（第3组）。糖尿病教育者每隔一周陪伴参与者监测目标，干预期持续3个月。主要结局是3个月时HbA1c相对于基线的变化。体重和体重指数（BMI）变化被视为次要结局。在783名筛查患者中，共有54名参与者（每个研究组18名）被纳入研究，44名（82%）完成了3个月的随访。第1组、第2组和第3组的平均基线HbA1c值分别为8.5%、7.9%和8.2%。3个月时，所有三个研究组的参与者HbA1c均有所降低，从第2组的-0.9%到第1组的-1.4%不等。体重和BMI也有所降低。3个月后，个人和混合现金激励措施使2型糖尿病患者的HbA1c、体重和BMI显著降低。干预措施的招募和接受情况成功完成，证明了开展更大规模有效性研究以测试糖尿病管理的个人和混合经济激励措施的可行性。注册信息：ClinicalTrials.gov标识符NCT02891382。
