Improving the collection of patient-reported outcomes: Key factors influencing completion and drop-off rates.

Abstract

e23204 Background: Incorporating patient-reported outcomes (PROs) into healthcare processes can improve patient engagement and inform clinical decision-making. However, achieving high adoption rates and minimizing drop-off can be challenging. Understanding the factors that contribute to completion and drop-off is essential to optimizing PRO survey design and implementation. Methods: We conducted a retrospective study of questionnaires sent to patients in 2024 at a major cancer center. The questionnaires were used across standard of care, research, and quality improvement projects. A governance process to oversee the development of questionnaires and related content was utilized to ensure satisfactory experience for patients. We analyzed metrics including the number of questionnaires developed, the number of questionnaires sent and completed, and patient burden as measured by completion time, drop-off rates defined as a questionnaire started but not completed, and median time to completion. We also identified the highest and lowest completion rates and drop-off rates across specific questionnaires. Results: A total of 1,181,058 responses were collected across all questionnaires. The median completion time was 2 minutes. Our analysis revealed significant variability in the completion rates, drop-off rates, and time to completion across survey categories. The standard of care questionnaires demonstrated the highest completion rate (72%) and the lowest drop-off rate (2%). In comparison, research questionnaires had a completion rate of 59% with a drop-off rate of 4%, and quality improvement questionnaires had a completion rate of 49% and a drop-off rate of 3%. Table 1 shows the 3 questionnaires with the highest drop-off rates. Conclusions: Our findings suggest that drop-off rates are significantly influenced by survey design and content complexity. The higher completion and lower drop-off rates observed in standard of care surveys underscore the importance of a governance structure to review questionnaire length, language, and integration with clinical workflows. While shorter completion times are important, they do not necessarily reduce drop-off if the survey is perceived as burdensome. For example, the Patient Values Assessment and other emotionally charged surveys can be more difficult for patients to complete, resulting in lower completion rates and higher drop-off. Our results suggest that refining survey design, tailoring content to patient needs, and optimizing integration into clinical workflows can improve patient participation in PRO surveys. Questionnaire Total Completed Completion Rate Drop-Off Rate Median Time to Complete (IQR) Family History Questionnaire 22,408 65% 21% 8.1 minutes (0, 32.8) COVID-19 Research Follow-Up Questionnaire 350 36% 19% 14.1 minutes (9.6, 379) Patient Values Assessment 879 59% 14% 9.25 minutes (3.8, 55.3)