Strategies to increase response rates for patient-reported outcome measures in orthopaedics: A scoping review

Low response rates remain a challenge for collecting patient-reported outcome measures (PROMs). This review aimed to identify and synthesise the strategies to increase PROM response rates in orthopaedic populations or settings that have been evaluated in the peer-reviewed literature. Such a synthesis can guide future research and provide a structure for future implementation evaluations.

We completed a scoping review of English-language articles in peer-reviewed journals published from 1 January 2013 to 30 October 2023 in PubMed, Embase via Ovid, and Scopus. Eligible articles had a primary focus on patients with orthopaedic conditions and/or described activities in an orthopaedic practice setting and had to present numeric data on response rates for (a) two or more strategies or (b) before and after a specific strategy.

Across 27 papers, the largest category of evaluated strategies was 'administration modality' (n = 16). Other categories of strategies included 'administration setting' (n = 5), 'manual effort' (n = 5), 'reminder' (n = 4), 'invitation' (n = 3), 'automation' (n = 3), 'education and training' (n = 3), 'measure characteristic' (n = 3), 'incentive' (n = 2), and 'administration frequency' (n = 1). Eighteen of 23 studies that completed significance testing identified a significant difference in favour of an intervention, but there were mixed findings across studies within categories.

Opportunities exist to evaluate categories of strategies beyond the technical modality of administration (e.g. paper vs. electronic) to increase response rates. Additionally, the review findings highlight the need for increased standardisation of terminology and improved specification of strategies and response rate outcomes for systematic implementation evaluations and cross-institutional comparisons.