This investigation used a multiple baseline design that followed the 77 participants (aged 14–21 years) with RF for a period of 15 months (3 months prior to intervention and 12 months afterwards). The study researchers sought to determine whether an incentive programme consisting of a mobile phone and monthly “top-up” (for data/calls) increased the number of secondary prophylaxis injections, increased texts/calls with nurses, reduced the number of visits to get a successful injection, less medicine wasted, and increased nurse satisfaction, compared to the baseline period prior to the intervention. All study participants were enrolled in an acute RF registry in the Waikato region and were classified by the number of injections at baseline as either fully adherent (all injections received and ≤1 late) or partially adherent. Following the intervention, injections were markedly increased and slightly decreased over time in the partially adherent cohort (p=0.003), while those classified as fully adherent maintained their high rate of injections. There was a similar pattern for satisfaction among the district nurses, who expressed higher rates of satisfaction with fully adherent patients than with those in the partially adherent cohort and, while nurses’ satisfaction for fully adherent patients fell slightly over time, satisfaction with partially adherent patients increased sharply post-intervention and then fell slightly over time (p=0.001). There was a significant increase throughout the intervention in the number of calls/texts placed by nurses to the partially adherent patients (p=0.003). The number of visits made by nurses fell over time with partially adherent patients and increased over time with fully adherent patients (p=0.012). The overall incremental cost-effectiveness for the 12-month study period was $NZ989 per extra successful injection.
