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Lottery incentive improved fecal occult blood test completion rates
Among several different financial incentives tested, a lottery-style cash reward increased rates of completion of fecal occult blood tests for colon cancer screening among veterans, according to new research data.
“Fecal occult blood tests (FOBTs) are inexpensive and an effective way to find colon cancer early and save lives,” Jeffrey T. Kullgren, MD, MS, MPH, from the VA Ann Arbor Healthcare System and University of Michigan Medical School, said in a press release. “It’s up to the patient, however, to do this test at home and, unfortunately, completion rates are low.”
Jeffrey T. Kullgren
Aiming to determine whether integrating modest financial incentives into usual care can increase rates of FOBT completion, Kullgren and colleagues performed a randomized controlled trial from February to October 2012 involving patients at the Philadelphia VA Medical Center who were prescribed an FOBT. In the first stage of the study, 713 patients were randomly assigned to usual care or receipt of $5, $10 or $20 for completion of an FOBT. None of these incentives increased 30-day FOBT completion rate. In the second stage, 836 patients were randomly assigned to usual care or receipt of $5, a one-in-10 chance of winning $50 or entry into a $500 raffle for completion of an FOBT. Only the one-in-10 chance of winning $50 increased FOBT completion compared with usual care (19.6% difference; 95% CI, 10.7-28.6). Subgroup analysis revealed that no incentives were more effective in previously nonadherent patients compared with patients who had completed an FOBT before.
“Our study is another example of how modest financial incentives may go a long way in improving health behaviors and health care quality,” Kullgren said in the release. “Integrating a small lottery incentive into usual care is a low-cost tool with potential to promote patients’ use of a service proven to save lives by catching cancer early.”
Disclosure: The researchers report no relevant financial disclosures.