A Two‐Center Randomized Controlled Trial to Assess Financial Incentives for Compliance With Living Kidney Donor Follow‐Up in the United States
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2025
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| author | Shivani S. Bisen Tanveen Ishaque Alvin G. Thomas Madeleine M. Waldram Daniel S. Warren Jaclyn Bannon Joseph R. Scalea Dorry L. Segev Jacqueline M. Garonzik‐Wang Allan B. Massie Macey L. Levan |
| author_facet | Shivani S. Bisen Tanveen Ishaque Alvin G. Thomas Madeleine M. Waldram Daniel S. Warren Jaclyn Bannon Joseph R. Scalea Dorry L. Segev Jacqueline M. Garonzik‐Wang Allan B. Massie Macey L. Levan Shivani S. Bisen Tanveen Ishaque Alvin G. Thomas Madeleine M. Waldram Daniel S. Warren Jaclyn Bannon Joseph R. Scalea Dorry L. Segev Jacqueline M. Garonzik‐Wang Allan B. Massie Macey L. Levan |
| collection | Wiley Open Access |
| contents | A Two‐Center Randomized Controlled Trial to Assess Financial Incentives for Compliance With Living Kidney Donor Follow‐Up in the United States Shivani S. Bisen Tanveen Ishaque Alvin G. Thomas Madeleine M. Waldram Daniel S. Warren Jaclyn Bannon Joseph R. Scalea Dorry L. Segev Jacqueline M. Garonzik‐Wang Allan B. Massie Macey L. Levan Clinical Transplantation ABSTRACT Introduction The United States Organ Procurement and Transplantation Network mandates collection of 6‐month, 1‐year, and 2‐year post‐donation follow‐up data on living kidney donors (LKDs), but many centers struggle to meet these requirements. This study investigated whether providing a financial incentive (mailed gift card) could increase patient compliance with LKD follow‐up. Methods A parallel, non‐blinded, 1:1 superiority randomized control trial of LKDs was conducted at two centers from March 2017 to February 2021. The control arm received standard of care (SOC): instructions to complete the mandated LKD follow‐up consisting of a health questionnaire and laboratory measurements at 6 months, 1 year, and 2 years post‐donation. The intervention arm received SOC and was mailed a $25 gift card for each timely completed follow‐up. Compliance rates were compared at each timepoint using Poisson regression. Results A total of 175 donors consented to participate. The 6‐month, 1‐year, and 2‐year follow‐up compliance rates were 65.2%, 63%, and 65.2% in the control arm, and 71.1%, 60.2%, and 53.0% in the intervention arm, respectively. No statistically significant improvement in compliance was observed with the gift card intervention (IRR = 0.89 1.09 1.34 at 6 months, 0.76 0.96 1.21 at 1 year, and 0.63 0.81 1.05 at 2 years). Similarly, no differences were observed in compliance with clinical follow‐up, laboratory follow‐up, or individual questions or lab values. Conclusion Mailed gift cards did not improve patient compliance with LKD follow‐up requirements; such interventions may be counterproductive among LKDs. Further research is needed to investigate and address barriers to completing LKD follow‐up. Trial Registration ClinicalTrials.gov identifier: NCT03090646 10.1111/ctr.70401 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/ctr.70401 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_ctr_70401 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | A Two‐Center Randomized Controlled Trial to Assess Financial Incentives for Compliance With Living Kidney Donor Follow‐Up in the United States Shivani S. Bisen Tanveen Ishaque Alvin G. Thomas Madeleine M. Waldram Daniel S. Warren Jaclyn Bannon Joseph R. Scalea Dorry L. Segev Jacqueline M. Garonzik‐Wang Allan B. Massie Macey L. Levan Clinical Transplantation A Two‐Center Randomized Controlled Trial to Assess Financial Incentives for Compliance With Living Kidney Donor Follow‐Up in the United States Shivani S. Bisen Tanveen Ishaque Alvin G. Thomas Madeleine M. Waldram Daniel S. Warren Jaclyn Bannon Joseph R. Scalea Dorry L. Segev Jacqueline M. Garonzik‐Wang Allan B. Massie Macey L. Levan Clinical Transplantation ABSTRACT Introduction The United States Organ Procurement and Transplantation Network mandates collection of 6‐month, 1‐year, and 2‐year post‐donation follow‐up data on living kidney donors (LKDs), but many centers struggle to meet these requirements. This study investigated whether providing a financial incentive (mailed gift card) could increase patient compliance with LKD follow‐up. Methods A parallel, non‐blinded, 1:1 superiority randomized control trial of LKDs was conducted at two centers from March 2017 to February 2021. The control arm received standard of care (SOC): instructions to complete the mandated LKD follow‐up consisting of a health questionnaire and laboratory measurements at 6 months, 1 year, and 2 years post‐donation. The intervention arm received SOC and was mailed a $25 gift card for each timely completed follow‐up. Compliance rates were compared at each timepoint using Poisson regression. Results A total of 175 donors consented to participate. The 6‐month, 1‐year, and 2‐year follow‐up compliance rates were 65.2%, 63%, and 65.2% in the control arm, and 71.1%, 60.2%, and 53.0% in the intervention arm, respectively. No statistically significant improvement in compliance was observed with the gift card intervention (IRR = 0.89 1.09 1.34 at 6 months, 0.76 0.96 1.21 at 1 year, and 0.63 0.81 1.05 at 2 years). Similarly, no differences were observed in compliance with clinical follow‐up, laboratory follow‐up, or individual questions or lab values. Conclusion Mailed gift cards did not improve patient compliance with LKD follow‐up requirements; such interventions may be counterproductive among LKDs. Further research is needed to investigate and address barriers to completing LKD follow‐up. Trial Registration ClinicalTrials.gov identifier: NCT03090646 10.1111/ctr.70401 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | A Two‐Center Randomized Controlled Trial to Assess Financial Incentives for Compliance With Living Kidney Donor Follow‐Up in the United States |
| topic | Clinical Transplantation |
| url | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70401 |