A Two-Center Randomized Controlled Trial to Assess Financial Incentives for Compliance With Living Kidney Donor Follow-Up in the United States.
Bisen, S. S., et al.Clin Transplant. 2025 Dec;39(12):e70401.
Aims
The aim of this study was to investigate the effect of providing financial incentives for increasing compliance with follow-up among living kidney donors (LKDs).
Interventions
Participants were randomised to receive either standard of care (SOC) plus a $25 mailed gift card or SOC alone.
Participants
175 adult patients that underwent donor nephrectomy (≥ 18 years of age).
Outcomes
The primary endpoint was proportion of living kidney donors who submitted policy-defined complete follow-up data on time. The secondary endpoint was hospital-level compliance according to OPTN-mandated reporting standards.
Follow-up
2 year post-donation
CET Conclusions
This interesting RCT investigated the role of patient incentives in improving 6 month, 1- and 2-year follow-up compliance for living kidney donors in the US. Donors were randomised to standard care, or to receive a $25 gift card each time they completed a follow-up visit. The authors report that incentivising follow-up did not improve compliance with laboratory or data follow-up at any timepoint. The study is well-designed and reported, using variable block randomisation with adequate allocation concealment. The study was affected by the COVID pandemic – with a significant drop in follow-up rates after the start of the pandemic. It is therefore possible that any effect of financial incentive was overridden by the health concerns of attending a medical facility during the pandemic during this period. It is also possible that the small incentive offered was too little to overcome the inconvenience of complying with follow-up, and that those patients motivated to attend follow-up would have done so regardless of incentive.
Data analysis
Strict intention-to-treat analysis
Trial registration
ClinicalTrials.gov - NCT03090646