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Increasing follow-up questionnaire response rates in a randomized controlled trial of telehealth for depression: three embedded controlled studies

Edwards, Louisa; Salisbury, Chris; Horspool, Kimberley; Foster, Alexis; Garner, Katy; Montgomery, Alan A.

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Authors

Louisa Edwards

Chris Salisbury

Kimberley Horspool

Alexis Foster

Katy Garner

ALAN MONTGOMERY ALAN.MONTGOMERY@NOTTINGHAM.AC.UK
Director Nottingham Clinical Trials Unit



Abstract

Background: Attrition is problematic in trials, and may be exacerbated in longer studies, telehealth trials and participants with depression – three features of The Healthlines Study. Advance notification, including a photograph and using action-oriented email subject lines might increase response rates, but require further investigation. We examined the effectiveness of these interventions in three embedded Healthlines studies.
Methods: Based in different trial sites, participants with depression were alternately allocated to be pre-called or not ahead of the 8-month follow-up questionnaire (Study 1), randomized to receive a research team photograph or not with their 12-month questionnaire (Study 2), and randomized to receive an action-oriented (‘ACTION REQUIRED’) or standard (‘Questionnaire reminder’) 12-month email reminder (Study 3). Participants could complete online or postal questionnaires, and received up to five questionnaire reminders. The primary outcome was completion of the Patient Health Questionnaire (PHQ-9). Secondary outcome measures were the number of reminders and time to questionnaire completion.
Results: Of a total of 609 Healthlines depression participants, 190, 251 and 231 participants were included in Studies 1–3 (intervention: 95, 126 and 115), respectively. Outcome completion was ≥90 % across studies, with no differences between trial arms (Study 1: OR 0.38, 95 % CI 0.07–2.10; Study 2: OR 0.84, 95 % CI 0.26–2.66; Study 3: OR 0.53 95 % CI 0.19–1.49). Pre-called participants were less likely to require a reminder (48.4 % vs 62.1 %, OR 0.41, 95 % CI 0.21–0.78), required fewer reminders (adjusted difference in means −0.67, 95 % CI −1.13 to −0.20), and completed follow-up quicker (median 8 vs 15 days, HR 1.35, 95 % CI 1.00–1.82) than control subjects. There were no significant between-group differences in Studies 2 or 3.
Conclusions: Eventual response rates in this trial were high, with no further improvement from these interventions. While the photograph and email interventions were ineffective, pre-calling participants reduced time to completion. This strategy might be helpful when the timing of study completion is important. Researchers perceived a substantial benefit from the reduction in reminders with pre-calling, despite no overall decrease in net effort after accounting for pre-notification.

Citation

Edwards, L., Salisbury, C., Horspool, K., Foster, A., Garner, K., & Montgomery, A. A. (2016). Increasing follow-up questionnaire response rates in a randomized controlled trial of telehealth for depression: three embedded controlled studies. Trials, 17, Article 107. https://doi.org/10.1186/s13063-016-1234-3

Journal Article Type Article
Acceptance Date Feb 16, 2016
Online Publication Date Feb 24, 2016
Publication Date Feb 24, 2016
Deposit Date Aug 10, 2017
Publicly Available Date Aug 10, 2017
Journal Trials
Electronic ISSN 1745-6215
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 17
Article Number 107
DOI https://doi.org/10.1186/s13063-016-1234-3
Keywords Depression, Email reminders, Embedded study, Photographs, Pre-notification, Recruitment, Response rates, Retention, Telehealth, Trials
Public URL https://nottingham-repository.worktribe.com/output/775388
Publisher URL https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-016-1234-3
Contract Date Aug 10, 2017

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