Factors Associated With Response to Patient-Reported Outcome Measures: A Systematic Review of Systematic Reviews and Meta-analyses
Author(s)
Sebastiaan T. Peters, MSc1, Joene Rutten, BSc1, Yara E. Van Kooij, MSc2, Ruud W. Selles, PhD1, Harm P. Slijper, PhD3, Robbert M. Wouters, PhD1.
1Erasmus MC, Rotterdam, Netherlands, 2Xpert Handtherapie, Utrecht, Netherlands, 3Equipe Zorgbedrijven, Eindhoven, Netherlands.
1Erasmus MC, Rotterdam, Netherlands, 2Xpert Handtherapie, Utrecht, Netherlands, 3Equipe Zorgbedrijven, Eindhoven, Netherlands.
OBJECTIVES: Routinely collecting patient-reported outcome measures (PROMs) is an important aspect of modern value-based healthcare. Using PROMs in daily clinical care can enhance care delivery, shared decision-making, and progress monitoring. Understanding the factors associated with non-response to digitally collected PROMs is crucial to improve response with targeted interventions. This study investigated factors associated with response to digitally collected PROMs.
METHODS: We performed a systematic review of systematic reviews. An electronic search was conducted across five databases. The AMSTAR tool was used to assess the risk of bias. We used the risk of bias score in a predefined best-evidence synthesis to determine the level of evidence. Additionally, we performed a meta-analysis.
RESULTS: We included six SRs. Three studies examined factors influencing responses to digitally collected PROMs, while the other three also examined responses to nondigitally collected PROMs. We identified forty-eight factors that were positively, negatively, or not associated with the response to digitally collected PROMs. Some are directly modifiable, including the overload or overlap of questions, PROMs irrelevant to the patient, automatic reminders, system usability, and caregivers' follow-up with PROMs. While others are non-modifiable, such as race, language barriers, visual impairments, and comorbidities, possibly reflecting a deeper issue of unequal access to care.
CONCLUSIONS: Response to digitally collected PROMs is multidimensional and determined by a range of factors, including sociodemographic characteristics, physical health, psychosocial status, PROM characteristics, technological factors, treatment characteristics, and external influences. This review provides a generalizable, comprehensive overview of these factors to guide the development of targeted interventions that improve PROM response rates and enhance equitable value-based healthcare. Future research may focus on interventions that effectively improve response rates. Potential interventions may include reducing PROM items, providing personalized reminders, overcoming language barriers, and enhancing the user interface for patients with, for instance, lower digital literacy or visual impairments.
METHODS: We performed a systematic review of systematic reviews. An electronic search was conducted across five databases. The AMSTAR tool was used to assess the risk of bias. We used the risk of bias score in a predefined best-evidence synthesis to determine the level of evidence. Additionally, we performed a meta-analysis.
RESULTS: We included six SRs. Three studies examined factors influencing responses to digitally collected PROMs, while the other three also examined responses to nondigitally collected PROMs. We identified forty-eight factors that were positively, negatively, or not associated with the response to digitally collected PROMs. Some are directly modifiable, including the overload or overlap of questions, PROMs irrelevant to the patient, automatic reminders, system usability, and caregivers' follow-up with PROMs. While others are non-modifiable, such as race, language barriers, visual impairments, and comorbidities, possibly reflecting a deeper issue of unequal access to care.
CONCLUSIONS: Response to digitally collected PROMs is multidimensional and determined by a range of factors, including sociodemographic characteristics, physical health, psychosocial status, PROM characteristics, technological factors, treatment characteristics, and external influences. This review provides a generalizable, comprehensive overview of these factors to guide the development of targeted interventions that improve PROM response rates and enhance equitable value-based healthcare. Future research may focus on interventions that effectively improve response rates. Potential interventions may include reducing PROM items, providing personalized reminders, overcoming language barriers, and enhancing the user interface for patients with, for instance, lower digital literacy or visual impairments.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
CO122
Topic
Clinical Outcomes, Patient-Centered Research, Real World Data & Information Systems
Topic Subcategory
Clinical Outcomes Assessment
Disease
Personalized & Precision Medicine