Improving response rates using a monetary incentive for patient completion of questionnaires: an observational study

Stephen D Brealey; Christine Atwell; Stirling Bryan; Simon Coulton; Helen Cox; Ben Cross; Fiona Fylan; Andrew Garratt; Fiona J Gilbert; Maureen G C Gillan; Maggie Hendry; Kerenza Hood; Helen Houston; David King; Veronica Morton; Jo Orchard; Michael Robling; Ian T Russell; David Torgerson; Valerie Wadsworth; Clare Wilkinson

doi:10.1186/1471-2288-7-12

Improving response rates using a monetary incentive for patient completion of questionnaires: an observational study

Stephen D Brealey, Christine Atwell, Stirling Bryan, Simon Coulton, Helen Cox, Ben Cross, Fiona Fylan, Andrew Garratt, Fiona J Gilbert, Maureen G C Gillan, Maggie Hendry, Kerenza Hood, Helen Houston, David King, Veronica Morton, Jo Orchard, Michael Robling, Ian T Russell, David Torgerson, Valerie WadsworthClare Wilkinson

Applied Medicine

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Abstract

Background: Poor response rates to postal questionnaires can introduce bias and reduce the statistical power of a study. To improve response rates in our trial in primary care we tested the effect of introducing an unconditional direct payment of 5 pound for the completion of postal questionnaires.

Methods: We recruited patients in general practice with knee problems from sites across the United Kingdom. An evidence-based strategy was used to follow-up patients at twelve months with postal questionnaires. This included an unconditional direct payment of 5 pound to patients for the completion and return of questionnaires. The first 105 patients did not receive the 5 pound incentive, but the subsequent 442 patients did. We used logistic regression to analyse the effect of introducing a monetary incentive to increase the response to postal questionnaires.

Results: The response rate following reminders for the historical controls was 78.1% ( 82 of 105) compared with 88.0% ( 389 of 442) for those patients who received the 5 pound payment (diff = 9.9%, 95% CI 2.3% to 19.1%). Direct payments significantly increased the odds of response ( adjusted odds ratio = 2.2, 95% CI 1.2 to 4.0, P = 0.009) with only 12 of 442 patients declining the payment. The incentive did not save costs to the trial - the extra cost per additional respondent was almost 50 pound.

Conclusion: The direct payment of 5 pound significantly increased the completion of postal questionnaires at negligible increase in cost for an adequately powered study.

Original language	English
Article number	12
Number of pages	5
Journal	BMC Medical Research Methodology
Volume	7
DOIs	https://doi.org/10.1186/1471-2288-7-12
Publication status	Published - 27 Feb 2007

Keywords

randomized controlled-trials
primary-care

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10.1186/1471-2288-7-12

Improving response
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Brealey, S. D., Atwell, C., Bryan, S., Coulton, S., Cox, H., Cross, B., Fylan, F., Garratt, A., Gilbert, F. J., Gillan, M. G. C., Hendry, M., Hood, K., Houston, H., King, D., Morton, V., Orchard, J., Robling, M., Russell, I. T., Torgerson, D., ... Wilkinson, C. (2007). Improving response rates using a monetary incentive for patient completion of questionnaires: an observational study. BMC Medical Research Methodology, 7, Article 12. https://doi.org/10.1186/1471-2288-7-12

Brealey, SD, Atwell, C, Bryan, S, Coulton, S, Cox, H, Cross, B, Fylan, F, Garratt, A, Gilbert, FJ, Gillan, MGC, Hendry, M, Hood, K, Houston, H, King, D, Morton, V, Orchard, J, Robling, M, Russell, IT, Torgerson, D, Wadsworth, V & Wilkinson, C 2007, 'Improving response rates using a monetary incentive for patient completion of questionnaires: an observational study', BMC Medical Research Methodology, vol. 7, 12. https://doi.org/10.1186/1471-2288-7-12

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abstract = "Background: Poor response rates to postal questionnaires can introduce bias and reduce the statistical power of a study. To improve response rates in our trial in primary care we tested the effect of introducing an unconditional direct payment of 5 pound for the completion of postal questionnaires.Methods: We recruited patients in general practice with knee problems from sites across the United Kingdom. An evidence-based strategy was used to follow-up patients at twelve months with postal questionnaires. This included an unconditional direct payment of 5 pound to patients for the completion and return of questionnaires. The first 105 patients did not receive the 5 pound incentive, but the subsequent 442 patients did. We used logistic regression to analyse the effect of introducing a monetary incentive to increase the response to postal questionnaires.Results: The response rate following reminders for the historical controls was 78.1% ( 82 of 105) compared with 88.0% ( 389 of 442) for those patients who received the 5 pound payment (diff = 9.9%, 95% CI 2.3% to 19.1%). Direct payments significantly increased the odds of response ( adjusted odds ratio = 2.2, 95% CI 1.2 to 4.0, P = 0.009) with only 12 of 442 patients declining the payment. The incentive did not save costs to the trial - the extra cost per additional respondent was almost 50 pound.Conclusion: The direct payment of 5 pound significantly increased the completion of postal questionnaires at negligible increase in cost for an adequately powered study.",

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author = "Brealey, {Stephen D} and Christine Atwell and Stirling Bryan and Simon Coulton and Helen Cox and Ben Cross and Fiona Fylan and Andrew Garratt and Gilbert, {Fiona J} and Gillan, {Maureen G C} and Maggie Hendry and Kerenza Hood and Helen Houston and David King and Veronica Morton and Jo Orchard and Michael Robling and Russell, {Ian T} and David Torgerson and Valerie Wadsworth and Clare Wilkinson",

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AU - Brealey, Stephen D

AU - Atwell, Christine

AU - Bryan, Stirling

AU - Coulton, Simon

AU - Cox, Helen

AU - Cross, Ben

AU - Fylan, Fiona

AU - Garratt, Andrew

AU - Gilbert, Fiona J

AU - Gillan, Maureen G C

AU - Hendry, Maggie

AU - Hood, Kerenza

AU - Houston, Helen

AU - King, David

AU - Morton, Veronica

AU - Orchard, Jo

AU - Robling, Michael

AU - Russell, Ian T

AU - Torgerson, David

AU - Wadsworth, Valerie

AU - Wilkinson, Clare

PY - 2007/2/27

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N2 - Background: Poor response rates to postal questionnaires can introduce bias and reduce the statistical power of a study. To improve response rates in our trial in primary care we tested the effect of introducing an unconditional direct payment of 5 pound for the completion of postal questionnaires.Methods: We recruited patients in general practice with knee problems from sites across the United Kingdom. An evidence-based strategy was used to follow-up patients at twelve months with postal questionnaires. This included an unconditional direct payment of 5 pound to patients for the completion and return of questionnaires. The first 105 patients did not receive the 5 pound incentive, but the subsequent 442 patients did. We used logistic regression to analyse the effect of introducing a monetary incentive to increase the response to postal questionnaires.Results: The response rate following reminders for the historical controls was 78.1% ( 82 of 105) compared with 88.0% ( 389 of 442) for those patients who received the 5 pound payment (diff = 9.9%, 95% CI 2.3% to 19.1%). Direct payments significantly increased the odds of response ( adjusted odds ratio = 2.2, 95% CI 1.2 to 4.0, P = 0.009) with only 12 of 442 patients declining the payment. The incentive did not save costs to the trial - the extra cost per additional respondent was almost 50 pound.Conclusion: The direct payment of 5 pound significantly increased the completion of postal questionnaires at negligible increase in cost for an adequately powered study.

AB - Background: Poor response rates to postal questionnaires can introduce bias and reduce the statistical power of a study. To improve response rates in our trial in primary care we tested the effect of introducing an unconditional direct payment of 5 pound for the completion of postal questionnaires.Methods: We recruited patients in general practice with knee problems from sites across the United Kingdom. An evidence-based strategy was used to follow-up patients at twelve months with postal questionnaires. This included an unconditional direct payment of 5 pound to patients for the completion and return of questionnaires. The first 105 patients did not receive the 5 pound incentive, but the subsequent 442 patients did. We used logistic regression to analyse the effect of introducing a monetary incentive to increase the response to postal questionnaires.Results: The response rate following reminders for the historical controls was 78.1% ( 82 of 105) compared with 88.0% ( 389 of 442) for those patients who received the 5 pound payment (diff = 9.9%, 95% CI 2.3% to 19.1%). Direct payments significantly increased the odds of response ( adjusted odds ratio = 2.2, 95% CI 1.2 to 4.0, P = 0.009) with only 12 of 442 patients declining the payment. The incentive did not save costs to the trial - the extra cost per additional respondent was almost 50 pound.Conclusion: The direct payment of 5 pound significantly increased the completion of postal questionnaires at negligible increase in cost for an adequately powered study.

KW - randomized controlled-trials

KW - primary-care

U2 - 10.1186/1471-2288-7-12

DO - 10.1186/1471-2288-7-12

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VL - 7

JO - BMC Medical Research Methodology

JF - BMC Medical Research Methodology

M1 - 12

ER -

Improving response rates using a monetary incentive for patient completion of questionnaires: an observational study

Abstract

Keywords

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