A test of financial incentives to improve warfarin adherence
2008

Using Lottery-Based Financial Incentives to Improve Warfarin Adherence

Sample size: 20 publication Evidence: moderate

Author Information

Author(s): Kevin G Volpp, George Loewenstein, Andrea B Troxel, Jalpa Doshi, Maureen Price, Mitchell Laskin, Stephen E Kimmel

Primary Institution: University of Pennsylvania

Hypothesis

Can a lottery-based daily financial incentive improve warfarin adherence and anticoagulation control?

Conclusion

A daily lottery-based financial incentive showed significant potential for improving warfarin adherence and anticoagulation control.

Supporting Evidence

  • The first pilot study showed a decrease in out-of-range INRs from 35.0% to 12.2% during the intervention.
  • The mean proportion of incorrect pills taken dropped from 22% to 2.3% in the first pilot.
  • In the second pilot, the time out of INR range decreased from 65.0% to 40.4%.

Takeaway

This study tested a fun way to help people remember to take their medicine by using a lottery. It worked well to get people to take their warfarin correctly.

Methodology

Two pilot studies with 10 participants each used a lottery system to incentivize adherence to warfarin over a 3-month period.

Potential Biases

Potential bias due to the non-randomized design and small sample size.

Limitations

The study was not a randomized controlled trial, and the effects may not be sustained long-term.

Participant Demographics

Patients aged 21 and older from the University of Pennsylvania Anticoagulation Management Center.

Digital Object Identifier (DOI)

10.1186/1472-6963-8-272

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