P79. Development of an evidence-based framework to increase patient-reported outcome response rates for orthopedic practices

Abstract

<h3>BACKGROUND CONTEXT</h3> Collection of patient-reported outcomes (PROs) is increasingly viewed as the standard of care in various orthopedic surgeries given the intrinsic need for quality metrics and outcome collection requirements from government agencies and insurance carriers. Despite these incentives, low response rates to PRO collection tools remain a problem. Currently, most studies that address PRO response rates mainly focus on patients and few studies analyze strategies to improve response rates. To date, an evidence-based overview of successful PRO collection strategies incorporated into an overarching human-centered design framework is still absent. <h3>PURPOSE</h3> We aimed to systematically review existing literature, synthesize evidence, and develop an overarching framework of strategies to increase PRO collection rates. <h3>METHODS</h3> First, we systematically searched existing literature from 06-2011 to 06-2021 (using PubMed, EMBASE, Scopus, Business Source Complete) for studies that 1) included a primary or secondary outcome of PRO response rates evaluating one or more interventions, 2) included the PRO response rate achieved for each comparator group, 3) calculated response rates per PRO, 4) involved an orthopedic practice, 5) involved mainly adults. Included studies were assessed according to their focus on survey collection tool design or patient engagement; subsequently, a human-centered design approach was used to develop an evidence-based framework. In order to develop a comprehensive framework for strategies to increase PRO response rates, we developed a two-pronged framework: survey collection tool strategies and patient engagement strategies. <h3>RESULTS</h3> Among 15 included studies (conducted in 3 countries) there were 3 randomized controlled trials, 1 prospective study and 11 retrospective studies. PRO response rates achieved by interventions ranged from 46% to 100%; 3 studies included more than one intervention, and only 1 of these studies looked at each intervention separately. The remaining two were unable to identify which specific intervention was most effective. The most common intervention studied was the method of survey distribution modality, however, modalities' effectiveness was not uniform. Additional interventions studied were: dedicated research assistants, length of surveys, frequency of surveys, automated provider reminders and communication regarding standard of care. Having a dedicated research assistant, shorter surveys, and automated reminders for the provider showed an increase in response rate. Color-coding indicates which strategies have been studied and examples are included in italics. There are significant gaps in the literature, especially on the patient engagement side. The strategy studied most for patient engagement is the number of dedicated research assistants, which has higher associated costs due to dedicated labor hours. <h3>CONCLUSIONS</h3> Considering the two aspects of survey data collection: survey collection tool design and patient engagement, current literature has prioritized the former, leaving a considerable gap in the orthopedic community's understanding of strategies to improve PRO response rate. The framework presented strives to provide a systematic roadmap for orthopedic practices seeking to increase PRO response rates that do not drastically increase cost. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.