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Type: Journal article
Title: Improving attendance for cardiovascular risk assessment in Australian general practice: an RCT of a monetary incentive for patients
Author: Stocks, N.
Allan, J.
Frank, O.
Williams, S.
Ryan, P.
Citation: BMC Family Practice, 2012; 13(1):1-6
Publisher: BioMed Central Ltd.
Issue Date: 2012
ISSN: 1471-2296
Statement of
Nigel Stocks, James Allan, Oliver Frank, Sue Williams and Philip Ryan
Abstract: Background: Preventive health care is an important part of general practice however uptake of activities by patients is variable. Monetary incentives for doctors have been used in the UK and Australia to improve rates of screening and immunisation. Few studies have focussed on incentives for patients to attend preventive health care examinations. Our objective was to investigate the use of a monetary incentive to increase patient attendance with their general practitioner for a cardiovascular risk assessment (CVRA). Methods: A pragmatic RCT was conducted in two Australian general practices. Participating GPs underwent academic detailing for cardiovascular risk assessment. 301 patients aged 40–74, who did not have cardiovascular disease, were independently randomised to receive a letter inviting them to a no cost cardiovascular risk assessment with their GP, or the same letter plus an offer of a $25 shopping voucher if they attended. An audit of patient medical records was also undertaken and a patient questionnaire administered to a sub sample of participants. Our main outcome measure was attendance for cardiovascular risk assessment. Results: In the RCT, 56/301(18.6%) patients attended for cardiovascular risk assessment, 29/182 (15.9%) in the control group and 27/119 (22.7%) in the intervention group. The estimated difference of 6.8% (95% CI: -2.5% to 16.0%) was not statistically significant, P = 0.15. The audit showed that GPs may underestimate patients’ absolute cardiovascular risk and the questionnaire that mailed invitations from GPs for a CVRA may encourage patients to attend. Conclusions: A small monetary incentive does not improve attendance for cardiovascular risk assessment. Further research should be undertaken to determine if there are other incentives that may increase attendance for preventive activities in the general practice setting.
Keywords: Humans
Pain Measurement
Risk Assessment
Health Knowledge, Attitudes, Practice
Family Practice
Socioeconomic Factors
Middle Aged
Patient Participation
Preventive Health Services
Reimbursement, Incentive
Primary Health Care
Quality Assurance, Health Care
Clinical Audit
Surveys and Questionnaires
Outcome Assessment, Health Care
Description: Extent: 6p.
Rights: © 2012 Stocks et al.; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: 10.1186/1471-2296-13-54
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General Practice publications

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