1. Converting from face-to-face to postal follow-up and its effects on participant retention, response rates and errors:lessons from the EQUAL study in the UK
- Author
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Gates, E., Hole, B., Hayward, S., Chesnaye, N.C., Meuleman, Y., Dekker, F.W., Evans, M., Heimburger, O., Torino, C., Porto, G., Szymczak, M., Drechsler, C., Wanner, C., Jager, K.J., Roderick, P., Caskey, F., EQUAL Investigators, Medical Informatics, ACS - Pulmonary hypertension & thrombosis, APH - Aging & Later Life, APH - Methodology, APH - Quality of Care, APH - Global Health, and APH - Health Behaviors & Chronic Diseases
- Subjects
Medicine (General) ,retention ,Epidemiology ,Errors ,Health Informatics ,Face-to-face ,R5-920 ,response rates ,Chronic kidney disease ,follow-up ,Humans ,errors ,Prospective Studies ,Pandemics ,prospective cohort study ,SARS-CoV-2 ,Follow-up ,COVID-19 ,Response rates ,United Kingdom ,Prospective cohort study ,Retention ,Optometry ,Psychology ,chronic kidney disease ,Follow-Up Studies - Abstract
Background Prospective cohort studies are challenging to deliver, with one of the main difficulties lying in retention of participants. The need to socially distance during the COVID-19 pandemic has added to this challenge. The pre-COVID-19 adaptation of the European Quality (EQUAL) study in the UK to a remote form of follow-up for efficiency provides lessons for those who are considering changing their study design. Methods The EQUAL study is an international prospective cohort study of patients ≥65 years of age with advanced chronic kidney disease. Initially, patients were invited to complete a questionnaire (SF-36, Dialysis Symptom Index and Renal Treatment Satisfaction Questionnaire) at research clinics every 3–6 months, known as “traditional follow-up” (TFU). In 2018, all living patients were invited to switch to “efficient follow-up” (EFU), which used an abbreviated questionnaire consisting of SF-12 and Dialysis Symptom Index. These were administered centrally by post. Response rates were calculated using returned questionnaires as a proportion of surviving invitees, and error rates presented as the average percentage of unanswered questions or unclear answers, of total questions in returned questionnaires. Response and error rates were calculated 6-monthly in TFU to allow comparisons with EFU. Results Of the 504 patients initially recruited, 236 were still alive at the time of conversion to EFU; 111 of these (47%) consented to the change in follow-up. In those who consented, median TFU was 34 months, ranging from 0 to 42 months. Their response rates fell steadily from 88% (98/111) at month 0 of TFU, to 20% (3/15) at month 42. The response rate for the first EFU questionnaire was 60% (59/99) of those alive from TFU. With this improvement in response rates, the first EFU also lowered errors to baseline levels seen in early follow-up, after having almost trebled throughout traditional follow-up. Conclusions Overall, this study demonstrates that administration of shorter follow-up questionnaires by post rather than in person does not negatively impact patient response or error rates. These results may be reassuring for researchers who are trying to limit face-to-face contact with patients during the COVID-19 pandemic.
- Published
- 2022