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

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


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

Topics: H1, RA
Publisher: BioMed Central
Year: 2007
OAI identifier:

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  1. (1999). Barriers to Participation in Randomised Controlled Trials: A Systematic Review. doi

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