Increasing diabetes testing adherence with incentives in rural Northwestern Ontario.

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL Canadian Journal of Rural Medicine Pub Date : 2023-01-01 DOI:10.4103/cjrm.cjrm_11_22
Jai Mashru, Gabrielle Gagnon, Carly Kaus, Yvon Gagnon, Adam Moir
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Abstract

Introduction: The health outcomes of rural Canadians have been described as poor and can in some part be related to diabetes mellitus. Despite the high mortality and morbidity rates associated with the disease, compliance with management remains low. Research has shown that a small financial incentive used to modify patient behaviour, can improve outcomes in cardiac disease and exercise adherence. This study aims to evaluate if a small financial incentive awarded to rural Northwestern Ontario patients with diabetes who complete an haemoglobin A1c (HbA1c) test, would result in greater compliance in test completion.

Methods: Patients were recruited through two Northern rural clinics. Participants were divided into two groups: Group A received a financial incentive, whereas Group B received a letter of reminder. HbA1c tests were recorded every 6 months for 2 years and compliance was analysed using a t-test and Chi-square.

Results: One hundred and forty-six participants were recruited with 30 lost to follow-up. Overall, the incentive group completed a statistically significantly higher number of HbA1c tests compared to those in the control group. In addition, it was noted that there was an increase in test adherence for participants that received reminder letters, although not an initially expected outcome of the study.

Conclusion: The results suggest that either a financial incentive or a reminder directed towards rural Canadians could have a benefit in promoting health behaviours to subsequent medical management of diabetes mellitus.

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在安大略省西北部农村增加糖尿病检测的依从性。
引言:加拿大农村居民的健康状况被描述为较差,在某种程度上可能与糖尿病有关。尽管与该疾病相关的死亡率和发病率很高,但对治疗的依从性仍然很低。研究表明,用于改变患者行为的小额经济激励可以改善心脏病的结果和坚持锻炼。本研究旨在评估对安大略省西北部农村地区完成血红蛋白A1c (HbA1c)检测的糖尿病患者给予小额经济奖励是否会导致更大的测试完成依从性。方法:通过北部两家农村诊所招募患者。参与者被分成两组:A组收到金钱奖励,而B组收到一封提醒信。每6个月记录一次HbA1c检测,持续2年,采用t检验和卡方分析依从性。结果:招募了146名参与者,其中30人失去了随访。总的来说,与对照组相比,激励组完成的HbA1c检测数量在统计学上显著增加。此外,值得注意的是,收到提醒信的参与者的测试依从性有所增加,尽管这不是研究最初预期的结果。结论:对加拿大农村地区的糖尿病患者进行经济激励或提醒,有利于促进糖尿病患者的健康行为。
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来源期刊
Canadian Journal of Rural Medicine
Canadian Journal of Rural Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
1.70
自引率
18.20%
发文量
38
期刊介绍: The Canadian Journal of Rural Medicine (CJRM) is a quarterly peer-reviewed journal available in print form and on the Internet. It is the first rural medical journal in the world indexed in Index Medicus, as well as MEDLINE/PubMed databases. CJRM seeks to promote research into rural health issues, promote the health of rural and remote communities, support and inform rural practitioners, provide a forum for debate and discussion of rural medicine, provide practical clinical information to rural practitioners and influence rural health policy by publishing articles that inform decision-makers.
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