Financial Incentives for Living Kidney Donors

Recruiting at 1 trial location

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Johns Hopkins University

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 3

320 Participants Needed

Trial Summary

What is the purpose of this trial?

This study evaluates whether using small financial incentives increases patient compliance with nationally-mandated living kidney donor follow-up at 6-months, 1-year, and 2-years after donation. Half of participants will receive a financial incentive (mailed gift card) after completing required follow-up activities (brief questionnaire and lab draw), while the other half will be asked to complete the required follow-up activities but will not receive a financial incentive (current standard of care).

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Financial Incentive, Monetary Incentive, Financial Reward, Economic Motivation for living kidney donors?

Research shows that financial incentives can improve healthcare performance by motivating providers to achieve better results, as seen in programs for chronic kidney disease and other conditions. These incentives help overcome financial barriers and align rewards with desired outcomes, suggesting they could also encourage more people to become living kidney donors. ^{1 2 3 4 5}

Is it safe for living kidney donors to receive financial incentives?

The research suggests that living kidney donation is generally safe, but donors may face risks like increased chances of chronic diseases and psychosocial issues. Financial incentives are being studied to improve follow-up care, but safeguards are needed to prevent coercion and ensure donor safety. ^{6 7 8 9 10}

How do financial incentives for living kidney donors differ from other treatments for kidney donation?

Financial incentives for living kidney donors are unique because they offer monetary rewards to encourage individuals to donate a kidney, unlike traditional approaches that rely solely on altruism. This method is similar to financial incentives used in other health behaviors, like promoting physical activity, but it specifically targets increasing the number of kidney donations. ^{11 12 13 14 15}

Research Team

Daniel Warren, PhD

Principal Investigator

Johns Hopkins University

Eligibility Criteria

This trial is for adults over 18 who have donated a kidney at Johns Hopkins or University of Maryland Medical Centers, speak English, and live in the U.S. It's not for those who don't speak English or international donors.

Inclusion Criteria

I had a kidney removal surgery from a living donor at Johns Hopkins or University of Maryland Medical Center.

Exclusion Criteria

Non-English speaking live kidney donors

International live kidney donors

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Follow-up

Participants complete follow-up activities at 6-months, 1-year, and 2-years post-donation, including a brief questionnaire and lab draw

2 years

3 visits (in-person or virtual) at 6-months, 1-year, and 2-years

Incentive Evaluation

Evaluation of the effectiveness of financial incentives on compliance with follow-up activities

2 years

Treatment Details

Interventions

• Financial Incentive

Trial Overview The study tests if giving small financial rewards (gift cards) helps kidney donors follow up better after surgery. Participants are split into two groups: one gets gift cards after completing check-ups; the other does not.

Participant Groups

Group I: Financial Incentive Experimental Treatment 1 Intervention

Up to three gift cards to a major online retailer will be mailed to participants assigned to the intervention arm after complete (i.e. all components addressed) and timely (i.e. within the policy-defined follow-up period) submission of follow-up data at each 6-month, 1-year, and 2-year follow-up visit.

Group II: Standard of Care Active Control 1 Intervention

Participants in the control arm will be instructed to attend required follow-up as is standard of care, but will not receive a financial incentive.

Who Is Running the Clinical Trial?

Johns Hopkins University

Lead Sponsor

Trials

2,366

Recruited

15,160,000+

University of Maryland, Baltimore

Collaborator

Trials

729

Recruited

540,000+

The Living Legacy Foundation

Collaborator

Trials

1

Recruited

320+

University of Maryland School of Medicine

Collaborator

Trials

5

Recruited

790+

Findings from Research

Health care systems can enhance value for money by implementing both financial and non-financial incentive structures to improve performance and reduce financial barriers for providers.

There is no one-size-fits-all approach to incentives in health care; their effectiveness varies based on specific circumstances, and careful design involving stakeholders is crucial for success.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increasing performance of health care services within economic constraints: working towards improved incentive structures. Custers, T., Klazinga, NS., Brown, AD.[2019]

A systematic analysis of 394 online comments from New York Times readers revealed that most people have negative perceptions of financial incentives for health improvement, viewing them as absurd or a reward for irresponsibility.

While some individuals supported financial incentives as a cost-effective way to prevent chronic diseases, the overall sentiment emphasized a desire for greater personal responsibility in health management, which may hinder the acceptance of such programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The New York Times readers' opinions about paying people to take their medicine. Park, JD., Metlay, J., Asch, JM., et al.[2015]

A systematic review of 23 randomized controlled trials involving 6074 participants found that financial incentives significantly increased physical activity (PA), with most studies reporting positive effects during the intervention period.

Even after the removal of incentives, participants maintained higher daily step counts, suggesting that short-term financial incentives can lead to sustained increases in physical activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Financial incentives for physical activity in adults: systematic review and meta-analysis. Mitchell, MS., Orstad, SL., Biswas, A., et al.[2022]

This review aims to evaluate the effectiveness of financial incentives provided by employers to encourage physical activity among employees in high-income countries, focusing on adherence to programs and related health outcomes like sick leave.

The study will include randomized controlled trials and assess various factors such as age, gender, and implementation quality, with plans for meta-analysis if sufficient data is available, ensuring a comprehensive understanding of the impact of financial incentives on physical activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using financial incentives to increase physical activity among employees as a strategy of workplace health promotion: protocol for a systematic review. Heise, TL., Frense, J., Christianson, L., et al.[2021]

References

1. Germany pubmed.ncbi.nlm.nih.gov

Increasing performance of health care services within economic constraints: working towards improved incentive structures. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

The impact of financial incentives on the implementation of asthma or diabetes self-management: A systematic review. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Rise of pay for performance: implications for care of people with chronic kidney disease. [2007]

4. England pubmed.ncbi.nlm.nih.gov

Perceptions and experiences of financial incentives: a qualitative study of dialysis care in England. [2023]

5. Singapore pubmed.ncbi.nlm.nih.gov

Multidisciplinary care program in pre-end-stage kidney disease from 2010 to 2018 in Taiwan. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Minimizing morbidity of organ donation: analysis of factors for perioperative complications after living-donor nephrectomy in the United States. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Incentive models to increase living kidney donation: encouraging without coercing. [2023]

8. England pubmed.ncbi.nlm.nih.gov

Financial incentives versus standard of care to improve patient compliance with live kidney donor follow-up: protocol for a multi-center, parallel-group randomized controlled trial. [2021]

9. United States pubmed.ncbi.nlm.nih.gov

Long-Term Non-End-Stage Renal Disease Risks After Living Kidney Donation. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

Does financial compensation for living kidney donation change willingness to donate? [2023]

11. England pubmed.ncbi.nlm.nih.gov

Acceptability of financial incentives and penalties for encouraging uptake of healthy behaviours: focus groups. [2022]

12. United States pubmed.ncbi.nlm.nih.gov

The New York Times readers' opinions about paying people to take their medicine. [2015]

13. United States pubmed.ncbi.nlm.nih.gov

The effectiveness of financial incentives for health behaviour change: systematic review and meta-analysis. [2022]

14. England pubmed.ncbi.nlm.nih.gov

Financial incentives for physical activity in adults: systematic review and meta-analysis. [2022]

15. England pubmed.ncbi.nlm.nih.gov

Using financial incentives to increase physical activity among employees as a strategy of workplace health promotion: protocol for a systematic review. [2021]