A review of evidence regarding the effectiveness of offering patients financial incentives to lead healthier lifestyles has concluded that, while such an approach can be successful, more research is needed into the potential wider effects.
The use of financial incentives by the National Health Service to promote changes in health behaviour is growing in popularity, particularly as the Service shifts its focus onto disease prevention as opposed to cure.
In a report by Health England, published last month, chairman Julian Le Grand suggests that individual behaviours lying at the root of many health problems – such as smoking, excessive drinking, lack of exercise and a poor diet – could be tackled by offering people a financial carrot to change their lifestyles.
And such schemes are already being tested in health trusts around the country. A local health authority in Dundee, Scotland, for example, has introduced a 12-week scheme under which smokers will be given £12.50 a week for groceries if they have managed to not smoke, which will be checked by a carbon monoxide test.
In another initiative, the Young Foundation Health Launch Pad and Birmingham East and North PCT has set up a social enterprise in which those taking part in healthy activities – such as smoking cessation or undertaking medical reviews – will be awarded points that are redeemable for a variety of benefits, such as sports equipment and mobile phone vouchers.
But the effectiveness of such incentive schemes is yet to be determined. In a review of evidence available to date, published last week in the British Medical Journal, Theresa Marteau, Professor of Health Psychology at Kings College London, and colleagues, conclude that programmes designed to alter bad habits such as smoking or lack of exercise may indeed work better if financial incentives are offered for both initial and sustained changes.
According to the authors, such rewards might actually help people to achieve the healthier lifestyles that many aspire to, as, they claim, most people would prefer to eat a healthier diet and exercise more.
The researchers conclude that financial incentives are one of several ways to change health behaviour for the better and should therefore be viewed as part of a broad approach to tackle poor health across the nation.
However, they warn that health bribes can also have “unintended effects on motivation, informed choices, and the doctor-patient relationship”, and so stress that more studies are need to explore these issues further.
