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Factors associated with response to patient-reported outcome measures: a systematic review of systematic and scoping
Sebastiaan Tjènne Peters1,2,3,4, Joene Rutten5,6, Yara Eline van Kooij5,6,7
1Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, Erasmus MC Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. s.t.peters@erasmusmc.nl.
Purpose:
This study aimed to identify and synthesize factors associated with response to digitally collected patient-reported outcome measures (PROMs) among adult patients, to inform efforts to improve response rates.
Methods:
We performed a systematic review of systematic and scoping reviews across five databases. Risk of bias was assessed using A MeaSurement Tool To Assess Systematic Reviews (AMSTAR) and included in a best-evidence synthesis. Additionally, a meta-analysis was conducted using the primary studies from the included reviews that specifically reported on digitally collected PROMs.
Results:
We identified 43 factors positively, negatively, or not associated with response to digital PROMs, clustered in six domains. Some were modifiable, including the overload or overlap of questions, PROMs irrelevant to the patient, automatic reminders, system usability, and clinicians' follow-up with PROMs. Others were non-modifiable, such as race, language barriers, visual impairments, and comorbidities; many of these factors are shaped by patients' broader social and health-related circumstances and may therefore point to underlying structural or contextual barriers (e.g., limited access to resources, lower literacy, or health-related limitations). Such barriers may ultimately contribute to unequal access to care and are potentially actionable.
Conclusions:
Factors associated with response to digitally collected PROMs can be clustered into six domains: sociodemographic characteristics, physical health, psychosocial status, PROM characteristics, technological factors, treatment characteristics, and external influences. Although not all factors are directly modifiable, they can inform targeted and tailored interventions to improve response rates across diverse populations and support more equitable access to care. This review provides a structured overview to guide such efforts. Potential interventions could include language simplification, item reduction, follow-up during consultation, tailored reminders, and interface adaptations for patients with specific needs.
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