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BMC Medical Research Methodology
Published in: BMC Medical Research Methodology 1/2016

Open Access 01-12-2016 | Research article

Evaluation of the effects of an offer of a monetary incentive on the rate of questionnaire return during follow-up of a clinical trial: a randomised study within a trial

Authors: Pollyanna Hardy, Jennifer L. Bell, Peter Brocklehurst, on behalf of The Epidural and Position Trial Collaborative Group

Published in: BMC Medical Research Methodology | Issue 1/2016

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Abstract

Background

A systematic review on the use of incentives to promote questionnaire return in clinical trials suggest they are effective, but not all studies have sufficient funds to use them. Promising an incentive once data are returned can reduce the cost-burden of this approach, with possible further cost-savings if the offer were restricted to reminder letters only. This study aimed to evaluate the effect of promising a monetary incentive at first mailout versus a promise on reminder letters only.

Methods

This was a randomised Study Within A Trial (SWAT) nested within BUMPES, a multicentre randomised controlled trial of maternal position in the late stage of labour in women with an epidural. The follow-up questionnaire asked for information on the women’s health, wellbeing and health service use one year following the birth of their baby. Women who consented to be contacted were randomised to a promise of a monetary incentive at first mailout or a promise on reminder letters only. Women were given an option of completing the questionnaire on paper or on online. The incentive was posted out on receipt of a completed questionnaire. The primary outcome was the overall return rate, and secondary outcomes were the return rate without any chasing from the study office, and the total cost of the vouchers.

Results

A total of 1,029 women were randomised, 508 to the first mailout group and 518 to the reminder group. There was no evidence to suggest a difference between groups in the overall return rate (adjusted RR 1.03 (95 % CI 0.96 to 1.11), however the proportion returned without chasing was higher in the first mailout group (adjusted RR 1.22, 95 % CI 1.07 to 1.39). The total cost of the vouchers per participant was higher in the first mailout group (mean difference £4.56, 95 % CI £4.02 to £5.11).

Conclusions

Offering a monetary incentive when a reminder is required could be cost-effective depending on the sample size of the study and the resources available to administer the reminder letters.

Trial registration

The BUMPES Trial is registered with Current Controlled Trials: ISRCTN35706297, 26th August 2009.
Literature
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Edwards PJ, Roberts I, Clarke MJ, DiGuiseppi C, Wentz R, Kwan I, Cooper R, Felix LM, Pratap S. Methods to increase response to postal and electronic questionnaires (Review). Cochrane Database of Systematic Reviews; 2009. p. 1-527. Issue 3. Art. No.: MR000008.
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Brueton VC, Tierney J, Stenning S, Harding S, Meredith S, Nazareth I, Rait G. Strategies to improve retention in randomised trials. Cochrane Database Syst Rev; 2013. p. 1-126. Issue 12. Art. No.: MR000032.
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Khadjesari Z, Murray E, Kalaitzaki E, White IR, McCambridge J, Thompson SG, Wallace P, Godfrey C. Impact and Costs of Incentives to Reduce Attrition in Online Trials: Two Randomized Controlled Trials. J Med Internet Res. 2011;13(1), e26.CrossRefPubMedPubMedCentral
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Kenyon S, Pike K, Jones D, Taylor D, Salt A, Marlow N, Brocklehurst P. The effect of a monetary incentive on return of a postal health and development questionnaire: a randomised trial. BMC Health Serv Res. 2005;5:55. ISRCTN53994660.CrossRefPubMedPubMedCentral
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Kahan BC, Morris TP. Analysis of multicentre trials with continuous outcomes: when and how should we account for centre effects? Stat Med. 2013;32:1136–49.CrossRefPubMed
Metadata
Title
Evaluation of the effects of an offer of a monetary incentive on the rate of questionnaire return during follow-up of a clinical trial: a randomised study within a trial
Authors
Pollyanna Hardy
Jennifer L. Bell
Peter Brocklehurst
on behalf of The Epidural and Position Trial Collaborative Group
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Medical Research Methodology / Issue 1/2016
Electronic ISSN: 1471-2288
DOI
https://doi.org/10.1186/s12874-016-0180-9

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