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Mensajes de texto con incentivos aumentaron la respuesta a encuestas de resultados informados por pacientes en

Gemma Altinger¹, Sweekriti Sharma¹, Qiang Li²

¹Sydney School of Public Health, The University of Sydney and Institute for Musculoskeletal Health, Sydney Local Health District, Australia.

Journal of clinical epidemiology

|December 21, 2025

Abstracto

Objectives:

To determine if text message-based behavioral interventions could increase response rates to a patient reported outcomes survey in the emergency department (ED).

Study Design And Setting:

We conducted a study within a trial (SWAT), within the NUDG-ED trial. The NUDG-ED trial aimed to reduce low-value care for patients with back pain presenting to eight EDs in Sydney, Australia. This SWAT was a 3-arm randomized controlled trial nested within the NUDG-ED trial. After discharge from the ED, patients were randomized to receive one of three text message invitations to complete a follow-up patient reported outcome survey: a standard control message, or one of two behaviorally informed messages including either a prize draw incentive or pro-social framing. Our primary outcome measure was the response rate in each study group. We performed a linear mixed-effects model controlling for hospital heterogeneity and patient characteristics to estimate the Mean Difference (MD) in proportions with 95% Confidence Interval (CI), to determine the effectiveness of the behavioral interventions.

Results:

A total of 1,494 patients were randomized between 15 May 2024 and 29 January 2025. Of these, 52% were women, the median age was 46 years (IQR 35, 62), 43% were from disadvantaged areas and 51% were triaged with a clinically urgent condition. Baseline characteristics were balanced across all groups. Our primary analysis found that compared to the control, the prize draw incentive increased response rates (n = 997 patients, MD = 6.9%, 95% CI: 1.8% to 11.9%, p = 0.007). Our adjusted mixed-effects model also found a significant increase in response rates (n = 979 patients, MD = 6.4%, 95% CI 1.3% to 11.4%, p = 0.013). Compared to the control, the pro-social framing message showed no statistically significant difference in response rate (n = 996 patients, 17.2% vs. 21.1%, MD = 3.9%, 95% CI: -1.1% to 8.9%).

Conclusion:

In this randomized trial, a prize draw incentive modestly improved response rates to a patient reported outcomes survey in routine emergency care settings. Pro-social framing may have slightly increased response rates, but the effect was uncertain. Both behavioral approaches warrant further testing in routine care settings.

Palabras clave:

ensayo controlado aleatorio intervenciones conductuales departamento de emergencias intervenciones de empuje resultados informados por el paciente ensayo pragmático

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