The impact of incentives on the implementation of asthma or diabetes self-management: A systematic review

Tracy Jackson, Liam G Heaney, Michael Shields, Chi Yan Hui, Hilary Pinnock

Research output: Contribution to conferenceAbstractpeer-review

Abstract / Description of output

Introduction: Financial incentives (FI) are utilised in primary and secondary care to improve quality of care delivered to patients by rewarding practices or practitioners for achieving targets.

Aims and objectives: To systematically review the evidence investigating the impact of FI for implementation of supported self-management on organisational process outcomes, individual behavioural outcomes, and health outcomes for individuals with asthma or diabetes.

Methods: We followed Cochrane methodology, using a PICOS search strategy to search 8 databases, including a broad range of implementation methodologies. Studies were classified by robustness of methodology, number of participants and quality score (Cochrane). We used narrative synthesis due to heterogeneity.

Results: We identified 2017 articles; 11 met our inclusion criteria. Self-management outcomes identified were practice or practitioner performance scores for HbA1c testing (n=9), asthma self-management plan (n=1) and emergency department (ED) visits (n=1). Three studies were part of a larger incentive scheme; one focused on asthma; seven focused on diabetes. In one asthma study, the proportion receiving 'perfect care' (which includes written self-management plan) increased, and there were fewer ED visits in another study. In 9 diabetes studies, GP performance scores improved in 2/9, were unchanged in 6/9 and deteriorated in 1/9.

Conclusions: Results for the impact of FI on the implementation of self-management were mixed. Overall, the evidence suggests no impact in diabetes and a single study showed improved processes in asthma. Further research is needed to confirm these findings and understand how FI impact on care
Original languageEnglish
Publication statusPublished - 1 Sept 2016
EventEuropean Respiratory Society International Congress 2016 - , United Kingdom
Duration: 3 Sept 2016 → …


ConferenceEuropean Respiratory Society International Congress 2016
Country/TerritoryUnited Kingdom
Period3/09/16 → …


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