Evidence mapPaperPMID 37518086Full record

SynthesisBMJ open2023

Patient financial incentives to improve asthma management: a systematic review.

Jasmine Hine, Bohee Lee, Andrew Bush, Anna De Simoni, Chris Griffiths, Gaby Judah, Louise Fleming

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Jasmine HineAsthma UK Centre of Applied Research, National Heart and Lung Institute, Imperial College London, London, UK.ORCID 0000-0003-1802-7909
Bohee LeeAsthma UK Centre of Applied Research, Centre for Population Health Sciences, The University of Edinburgh Centre for Population Health Sciences, Edinburgh, UK.
Andrew BushAsthma UK Centre of Applied Research, National Heart and Lung Institute, Imperial College London, London, UK.
Anna De SimoniAsthma UK Centre of Applied Research; Institute of Population Health Sciences, Queen Mary University of London, London, UK.ORCID 0000-0001-6955-0885
Chris GriffithsAsthma UK Centre of Applied Research; Institute of Population Health Sciences, Queen Mary University of London, London, UK.ORCID 0000-0001-7935-8694
Gaby JudahDepartment of Surgery and Cancer, Imperial College London, London, UK.
Louise FlemingAsthma UK Centre of Applied Research, National Heart and Lung Institute, Imperial College London, London, UK l.fleming@imperial.ac.uk.
Asthma UK · GBQueen Mary University of London · GBImperial College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe objectives of this systematic review are to identify studies that assess the effectiveness of patient-directed financial incentive interventions to improve asthma management behaviours, determine overall effectiveness of financial incentives, identify design characteristics of effective interventions and assess the impact on longer-term outcomes in the context of asthma.

designSystematic review with narrative synthesis. DATA SOURCES: Electronic databases (MEDLINE, Embase, Global Health, PsycINFO, CINAHL, PubMed and Web of Science) and grey literature sources (NHS Digital, CORE, ProQuest, Clinical Trials Register and EU Clinical Trials Register) were searched in November 2021 and updated March 2023. ELIGIBLITY CRITERIA: Eligible articles assessed financial incentives to improve asthma management behaviours (attendance at appointments, medication adherence, tobacco smoke/allergen exposure, inhaler technique and asthma education) for patients with asthma or parents/guardians of children with asthma. Eligible study design included randomised controlled, controlled or quasi-randomised trials and retrospective/prospective cohort, case-controlled or pilot/feasibility studies. SYNTHESIS: A narrative synthesis was conducted; eligible studies were grouped by asthma management behaviours and financial incentive framework domains.

resultsWe identified 4268 articles; 8 met the inclusion criteria. The studies were from the USA (n=7) and the UK (n=1). Asthma management behaviours included attendance at appointments (n=4), reduction in smoke exposure (n=1) and medication adherence (n=3). Five studies demonstrated positive behaviour change, four of which were significant (attendance at appointments (n=3) showed significant differences between intervention and control: 73% and 49% in one study, 46.3% and 28.9% in another, and 35.7% and 18.9%, respectively; medication adherence (n=1) showed significant change from 80% during intervention to 33% post intervention). These four significant studies used 'positive gain', 'certain', 'fixed' financial incentives of smaller magnitude, given for 'all' instances of behaviour.

conclusionThere is some evidence that patient-directed financial incentives improve asthma management behaviours. However, in view of the wide heterogeneity in study design and measured outcomes, determining overall effectiveness was challenging. PROSPERO REGISTRATION NUMBER: CRD42021266679.

Indexed as

AsthmaMotivationChildHumansMedication AdherenceProspective StudiesRetrospective StudiesAdult thoracic medicineAsthmaPaediatric thoracic medicine

Identifiers

PMID37518086
PMCPMC10387620
OpenAlexW4385406605

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.