Zhang Qingqing, Wei Xue, Zheng Jing, Lu Yu, Wu Yucheng
Department of Pan-Vascular Management Center, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, People's Republic of China.
Department of Endocrinology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, 366 Taihu Road, Hailing District, Taizhou, 225300, Jiangsu, People's Republic of China.
Cost Eff Resour Alloc. 2024 Sep 27;22(1):71. doi: 10.1186/s12962-024-00579-4.
Web of Science, Cochrane library and PubMed were systematically searched up to January 2024 to identify studies examining the impact of financial incentives on diabetes management in patients. Studies were evaluated based on the robustness of their methodology, participant numbers, and quality scores. The Cochrane risk-of-bias tool was applied for randomized controlled trials, while the Newcastle-Ottawa Scale was used for non-randomized controlled trials to assess study quality. Due to the heterogeneity of the included studies, a narrative synthesis approach was utilized.
In the study, we included 12 published research studies. Five studies investigated the influence of financial incentives on patient behavior, all demonstrating a significant positive impact on behaviors such as blood glucose monitoring, medication adherence, and physical activity. 10 studies analyzed the impact of financial incentives on HbA1c levels in diabetes patients. Among them, 5 studies reported that financial incentives could improve HbA1c levels through longitudinal historical comparisons. The other 5 studies did not find significant improvements compared to the control group. Three studies explored long-term effects, two studies targeting the adolescent population had no impact, and one study targeting adults had a positive impact.
In summary, this review found that financial incentives can positively influence patient behavior and enhance compliance, but their impact on HbA1c levels is inconsistent. Financial incentives may help adult patients maintain behavior even after the withdrawal of incentives.
截至2024年1月，对Web of Science、Cochrane图书馆和PubMed进行了系统检索，以确定研究财务激励措施对患者糖尿病管理影响的研究。根据研究方法的稳健性、参与者数量和质量评分对研究进行评估。Cochrane偏倚风险工具用于随机对照试验，而纽卡斯尔-渥太华量表用于非随机对照试验以评估研究质量。由于纳入研究的异质性，采用了叙述性综合分析方法。
在该研究中，我们纳入了12项已发表的研究。5项研究调查了财务激励措施对患者行为的影响，均表明对血糖监测、药物依从性和体育活动等行为有显著的积极影响。10项研究分析了财务激励措施对糖尿病患者糖化血红蛋白（HbA1c）水平的影响。其中，5项研究报告称，通过纵向历史比较，财务激励措施可改善HbA1c水平。另外5项研究与对照组相比未发现显著改善。3项研究探讨了长期影响，两项针对青少年人群的研究没有影响，一项针对成年人的研究有积极影响。
总之，本综述发现财务激励措施可对患者行为产生积极影响并提高依从性，但其对HbA1c水平的影响并不一致。财务激励措施可能有助于成年患者即使在激励措施撤销后仍能维持行为。
