Effect of Financial Incentives on Hypertension Control: A Multicenter Randomized Controlled Trial in China

Area of Science:

• Public Health
• Behavioral Economics
• Clinical Trials

Background:

• Poorly controlled hypertension poses a significant global public health challenge.
• Incentive-based approaches, utilizing behavioral and economic principles, show potential for enhancing patient treatment adherence.

Purpose of the Study:

• To evaluate the efficacy of financial incentives in reducing blood pressure (BP) among patients with poorly controlled hypertension in China.
• To assess the impact of financial incentives on hypertension control rates and medication adherence.

Main Methods:

• A two-arm randomized controlled trial was conducted with participants randomized 1:1 to control and intervention groups.
• Both groups received WeChat-based standard hypertension management education and support.
• The intervention group additionally received process- and outcome-based financial incentives.

Main Results:

• No statistically significant differences in BP reduction were observed between the intervention and control groups at 12-month follow-up (Systolic BP P=0.639; Diastolic BP P=0.667).
• Hypertension control rates (20.8% vs 15.8%, P=0.318) and medication adherence (84.2% vs 86.2%, P=0.705) did not differ significantly between the groups.
• Short-term effectiveness of financial incentives for BP control was noted, but this effect did not sustain beyond 3 months.

Conclusions:

• Financial incentives demonstrated short-term efficacy in blood pressure management but failed to yield sustained improvements in hypertension control over 12 months.
• The study highlights the need for further research into optimal financial incentive structures and amounts for long-term blood pressure management.
• Sustained effects of incentive-based interventions for hypertension require further investigation.