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Trial registered on ANZCTR
Registration number
ACTRN12616001160426
Ethics application status
Approved
Date submitted
6/08/2016
Date registered
25/08/2016
Date last updated
24/04/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Paying Adolescents to Improve type 1 Diabetes by testing Blood Glucose (PAID4BG)
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Scientific title
Payment rewards for blood glucose testing to improve type 1 diabetes management in adolescents
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Secondary ID [1]
289867
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None
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Universal Trial Number (UTN)
U1111-1186-0826
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Trial acronym
PAID4BG
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 1 diabetes
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Condition category
Condition code
Metabolic and Endocrine
299740
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Reward schedule for those randomised to the reward group (2/3 chance, target 20 participants):
90-day monetary reward according to the following schedule: $0.20 per test up to a maximum of 8 tests per day, plus $0.20 bonus for 4 tests per day, and $0.20 bonus for obtaining at least 2 glucose test results between 4.5-8mmol/L per day. Maximum $2 per day, so maximum $180 over 90 days study intervention duration or minimum $20 over 90 days will be provided upon final 12 week meter review and HbA1c result. Monetary rewards will only be provided every 4 weeks for the first 90 days, upon presentation of BG meter for checking or upon email receipt of the direct electronic meter download results. Additional $20 will provided after 1 year when HbA1c is done and BG meter is presented for review or download at this time point.
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Intervention code [1]
295553
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Behaviour
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Comparator / control treatment
Reward schedule for those in the usual care group (1/3 chance, target 10 participants):
A much smaller $20 reward will be provided at 12 weeks and 1 year time points upon meter review/download and HbA1c result to ensure these tests are done and control participants don't drop out disproportionately.
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Control group
Active
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Outcomes
Primary outcome [1]
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Mean daily Self Monitoring of Blood Glucose (SMBG) frequency (assessed by meter download for the past 1 month)
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Assessment method [1]
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Timepoint [1]
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12 weeks
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Primary outcome [2]
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HbA1c (laboratory test)
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Assessment method [2]
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Timepoint [2]
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12 weeks
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Secondary outcome [1]
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Composite outcome of Change in diabetes self management efficacy and satisfaction by Problem Areas in Diabetes (PAID) and SF-12 questionnaires
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Assessment method [1]
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Timepoint [1]
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12 weeks and 1 year
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Secondary outcome [2]
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Non-Attendance in scheduled clinic appointments
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Assessment method [2]
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Timepoint [2]
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at 1 year
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Secondary outcome [3]
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Number of severe hypoglycaemia episodes (requiring assistance to recognise and/or treat) as reported by the patient and any clinical records
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Assessment method [3]
326485
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Timepoint [3]
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at 1 year
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Secondary outcome [4]
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Number of hospital admissions according to clinical records (electronic health information available in clinic)
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Assessment method [4]
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Timepoint [4]
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over 1 year period
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Eligibility
Key inclusion criteria
Inclusion criteria
*Type 1 diabetes – at least 12 months duration
*HbA1c > 75 mmol/mol in at least 2 consecutive tests
*Age 16-25 years
*Access to a computer to upload glucose meters and transmit proof of testing by email, or willing to come to clinic to provide this
*living in Counties Manukau Health area
*Mobile phone ownership to receive and send texts
*Able to perform SMBG and adjust own insulin
*SMBG frequency 2 or less per day (average over past 1 month)
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Minimum age
16
Years
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Maximum age
25
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
*Any medical condition or medications known to alter glycemic control
*Plans to change insulin delivery mode
*Using continuous glucose sensor
*Neurocognitive impairment or significant psychiatric issues
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
computerised random sequence generation
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
This is a pilot two arm RCT in which we plan to recruit 20 subjects in the intervention arm and 10 patients in the control arm. The pooled standard deviation (SD) of HbA1c in the Petry study was 13mmol/mol. Using this relatively large SD, indicates that a sample size of 20 intervention vs 10 control will give us 80% power to detect a difference in HbA1c of 14.8 mmol/mol between the two groups. using alpha of 0.05.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
2/09/2016
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Actual
4/11/2016
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Date of last participant enrolment
Anticipated
2/06/2017
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Actual
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Date of last data collection
Anticipated
2/06/2018
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
8080
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New Zealand
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State/province [1]
8080
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Funding & Sponsors
Funding source category [1]
294243
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Charities/Societies/Foundations
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Name [1]
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Graeme Mack Diabetes Research Grant, Diabetes NZ Auckland Branch
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Address [1]
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Diabetes NZ Auckland Branch
PO Box 13578, Onehunga
Auckland 1643
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Country [1]
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New Zealand
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Primary sponsor type
Individual
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Name
Rinki Murphy
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Address
Department of Medicine
FMHS
University of Auckland
Private bag 92019
Auckland 1142
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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None
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Address [1]
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None
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Country [1]
293078
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Health and Disability Ethics Committee
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Ethics committee address [1]
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Ministry of Health Ethics Department Freyberg Building Reception – Ground Floor 20 Aitken Street Wellington 6011
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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05/08/2016
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Approval date [1]
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02/09/2016
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Ethics approval number [1]
295667
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Summary
Brief summary
OBJECTIVES: To assess the impact of a 12 week financial reward programme to increase self monitoring of blood glucose (SMBG) and improve diabetes control in adolescents with poorly controlled type 1 diabetes METHODS: Two-arm, randomized, controlled trial of 30 adolescents. Key eligibility criteria will be type 1 diabetes, age 16-25 years, HbA1c > 75mmol/mol, living in Counties Manukau Health area, and history of SMBG frequency of 2 or less per day. Consenting participants will be randomized 2:1 to either intervention of monetary reward dependent on monthly evidence of daily SMBG (maximum of $2 per day, $180 over 90 days of study + $20 at 12 months) or control (standard care but small financial rewards of $20 at 90 days and $20 at 12 months, for HbA1c assessment and providing BG upload at these two timepoints). Primary outcomes will be mean daily SMBG frequency and HbA1c at 12 weeks and at 1 year. Assuming a standard deviation of 13mmol/mol in HbA1c, a sample size of 20 intervention vs 10 control will provide 80% power to detect a difference of 14.8mmol/mol HbA1c between the two groups. EXPECTED OUTCOMES: This novel study design explores a potentially cost-effective intervention designed to improve health care behavior of adolescents with type 1 diabetes in effort to improve their glycemic control and reduce risk of subsequent hospitalization and diabetes complications. Given the acceptability and increased effect of financial rewards to promote health behavior, which have been seen in recipients from greater social deprivation scores in other disorders, this type of intervention has the potential to reduce health inequalities, and could be adopted in other centres.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Rinki Murphy
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Address
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Department of Medicine
FMHS, University of Auckland
Private Bag 92019
Auckland 1142
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Country
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New Zealand
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Phone
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+6499236313
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Joyce Roberts
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Address
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Whitiora Diabetes Centre
100 Hospital Road
Otahuhu
Auckland 2025
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Country
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New Zealand
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Phone
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+64(0)21074061
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Rinki Murphy
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Address
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Department of Medicine
FMHS, University of Auckland
Private Bag 92019
Auckland 1142
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Country
68076
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New Zealand
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Phone
68076
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+6499236313
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Fax
68076
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Email
68076
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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