Financial incentives for breast cancer screening undermine informed choice

Bartholomew, Theodore; Colleoni, Mirela; Schmidt, Harald

doi:10.1136/bmj-2021-065726

Cited by 8 publications

(9 citation statements)

References 39 publications

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“…Providing financial rewards or reimbursements to patients who complete recommended breast cancer screening has shown promising results in improving screening rates. These incentives can include gift cards, cash rewards or reductions in healthcare costs associated with screening 33. This study included a financial incentive, the hospital-sponsored free raffle tickets for attendance to a National Football League Buffalo Bills game once patients completed mammogram screening.…”

Section: Discussionmentioning

confidence: 99%

Advancing health equity in improving breast cancer screening with the use of a mobile mammography bus in marginalised population: quality improvement project

Bakhai,

Ansari,

Sadeghi

et al. 2024

BMJ Open Qual

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BackgroundBreast cancer, the second leading cause of cancer-related deaths in women in the USA, is effectively treated through early detection and screening. This quality improvement (QI) project aimed to improve mammography screening rates from the baseline of 50% to 60% within 12 months for patients aged 50–74 years at an Internal Medicine Clinic.MethodsWe used the Plan, Do, Study, Act (PDSA) model. A multidisciplinary team used a fishbone diagram to identify barriers to suboptimal screening. The QI team created a driver diagram and process flow map. The mammogram screening rate was the outcome measure. Mammogram order and completion rates were the process measures. We implemented six PDSA cycles. Major interventions included the use of a nurse navigator, enhancements in health information technology, and education to patients, providers, and nursing staff. Mammograms were offered in a mobile bus, located in the hospital campus and in under-resourced inner-city neighbourhoods to improve the access. Data analysis was performed using monthly statistical process control charts.ResultsThe project exceeded its initial goal, achieving a breast cancer screening rate of 66% (n=490 of 744) during the study period and was sustainable at 69%, 3 months post-project. The mammogram order rate was 58% (n=432 of 744) and completion rate was 53% (n=231 of 432) within 12 months.ConclusionsWe attributed the success of this QI project to the education of patients, nurses and physicians, the use of a nurse navigator and engagement of a multidisciplinary team. Access to mobile mammography bus addressed the social determinants of health barriers in a marginalised population.

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Section: Discussionmentioning

confidence: 99%

Advancing health equity in improving breast cancer screening with the use of a mobile mammography bus in marginalised population: quality improvement project

Bakhai,

Ansari,

Sadeghi

et al. 2024

BMJ Open Qual

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show abstract

“…For example, Bartholomew et al raised concerns over the use of financial incentives in breast cancer screening, stating they may stimulate patients to make decisions they would not otherwise make, which can subsequently lead to patient harm (e.g. unnecessary treatment) [ 20 ]. However, the use of financial incentives in the context of our study is quite different.…”

Section: Discussionmentioning

confidence: 99%

Financial incentives to increase stool collection rates for microbiome studies in adult bone marrow transplant patients

et al. 2022

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Introduction In order to study the role of the microbiome in hematopoietic stem cell transplantation (HCT), researchers collect stool samples from patients at various time points throughout HCT. However, stool collection requires active subject participation and may be limited by patient reluctance to handling stool. Methods We performed a prospective study on the impact of financial incentives on stool collection rates. The intervention group consisted of allogeneic HCT patients from 05/2017-05/2018 who were compensated with a $10 gas gift card for each stool sample. The intervention group was compared to a historical control group of allogeneic HCT patients from 11/2016-05/2017 who provided stool samples before the incentive was implemented. To control for possible changes in collections over time, we also compared a contemporaneous control group of autologous HCT patients from 05/2017-05/2018 with a historical control group of autologous HCT patients from 11/2016-05/2017; neither autologous HCT group was compensated. The collection rate was defined as the number of samples provided divided by the number of time points we attempted to obtain stool. Results There were 35 allogeneic HCT patients in the intervention group, 19 allogeneic HCT patients in the historical control group, 142 autologous HCT patients in the contemporaneous control group (that did not receive a financial incentive), and 75 autologous HCT patients in the historical control group. Allogeneic HCT patients in the intervention group had significantly higher average overall collection rates when compared to the historical control group allogeneic HCT patients (80% vs 37%, p<0.0001). There were no significant differences in overall average collection rates between the autologous HCT patients in the contemporaneous control and historical control groups (36% vs 32%, p = 0.2760). Conclusion Our results demonstrate that a modest incentive can significantly increase collection rates. These results may help to inform the design of future studies involving stool collection.

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“…In the past decades, malignant tumor has become one of the leading categories of diseases causing vast loss of human life annually. − Although a malignant tumor is intrinsically difficult to cure, surgical resection provides a straightforward and effective treatment for most solid tumors. Unfortunately, residual tumor tissues or cells left behind surgery can usually redevelop into solid tumors locally or remotely, leading to tumor recurrence or metastasis which actually accounts for the mortality of most tumors. , On the other hand, surgical resection inevitably causes acute incisional pain, which can evoke both physiological and psychological stresses on patients and impair their postoperative rehabilitation. , To improve the outcome of surgical treatment for malignant solid tumors, there is an urgent and widespread need to resolve the problems of tumor recurrence and postoperative pain.…”

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confidence: 99%

Nanocrystals Slow-Releasing Ropivacaine and Doxorubicin to Synergistically Suppress Tumor Recurrence and Relieve Postoperative Pain

Peng,

Liu,

Chen

et al. 2023

ACS Nano

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Although surgical resection provides a straightforward and effective treatment for most malignant solid tumors, tumor recurrence and acute postoperative pain continue to be two big problems associated with this treatment. To resolve these problems, a nanocrystal composite slow-releasing ropivacaine and doxorubicin was fabricated in this study. Briefly, a self-assembling peptide was used to form nanoparticle complexes with the two drugs, based on which homogeneous nanocrystals were obtained by adjusting the pH. In cultured human melanoma cells, the nanocrystals exhibited improved antitumor activity due to a synergistic effect and enhanced cellular uptake of the two drugs. On the other hand, the nanocrystals could slowly release ropivacaine in vitro and in vivo, generating long-acting analgesia on the rat sciatic nerve block model and incisional pain model. On a nude mouse tumor resection model, the nanocrystals simultaneously suppressed the recurrence of solid tumor and relieved postoperative pain, indicating a potential postoperative treatment for tumor resection patients. This nanocrystal system also suggested a promising and facile strategy for developing multifunctional formulations combining different drugs, which could achieve better therapeutic outcomes in a synergistic and sustained manner.

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Financial incentives for breast cancer screening undermine informed choice

Cited by 8 publications

References 39 publications

Advancing health equity in improving breast cancer screening with the use of a mobile mammography bus in marginalised population: quality improvement project

Advancing health equity in improving breast cancer screening with the use of a mobile mammography bus in marginalised population: quality improvement project

Financial incentives to increase stool collection rates for microbiome studies in adult bone marrow transplant patients

Nanocrystals Slow-Releasing Ropivacaine and Doxorubicin to Synergistically Suppress Tumor Recurrence and Relieve Postoperative Pain

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