Judah, Gaby, Vlaev, Ivo, Gunn, Laura, King, Dominic, King, Derek, Valabhji, Jonathan, Darzi, Ara and Bicknell, Colin
(2016)
Incentives in diabetic eye assessment by screening (IDEAS): study protocol of a three-arm randomized controlled trial using financial incentives to increase screening uptake in London.
BMC Ophthalmology, 16
(28).
ISSN 1471-2415
Abstract
Background: Diabetes is an increasing public health problem in the UK and globally. Diabetic retinopathy is a
microvascular complication of diabetes, and is one of the leading causes of blindness in the UK working age
population. The diabetic eye screening programme in England aims to invite all people with diabetes aged 12 or
over for retinal photography to screen for the presence of diabetic retinopathy. However, attendance rates are only
81 %, leaving many people at risk of preventable sight loss.
Methods: This is a three arm randomized controlled trial to investigate the impact of different types of financial
incentives (based on principles from behavioral economics) on increasing attendance at diabetic eye screening
appointments in London. Eligible participants will be aged 16 or over, and are those who have been invited to
screening appointments annually, but who have not attended, or telephoned to rearrange an appointment, within
the last 24 months.
Eligible participants will be randomized to one of three conditions:
1. Control condition (usual invitation letter)
2. Fixed incentive condition (usual invitation letter, including a voucher for £10 if they attend their appointment)
3. Probabilistic incentive condition (invitation letter, including a voucher for a 1 in 100 chance of winning £1000
if they attend their appointment).
Participants will be sent invitation letters, and the primary outcome will be whether or not they attend their
appointment. One thousand participants will be included in total, randomized with a ratio of 1.4:1:1. In order to test
whether the incentive scheme has a differential impact on patients from different demographic or socio-economic
groups, information will be recorded on age, gender, distance from screening center, socio-economic status and
length of time since they were last screened. A cost-effectiveness analysis will also be performed.
Discussion: This study will be the first trial of financial incentives for improving uptake of diabetic eye screening. If
effective, the intervention may suggest a cost-effective way to increase screening rates, thus reducing unnecessary
blindness.
Actions (login required)
 |
Record administration - authorised staff only |
Download statistics
Download statistics