Socioeconomic deprivation and age are barriers to the online collection of patient reported outcome measures in orthopaedic patients

Abstract

Introduction Questionnaires are used commonly to assess functional outcome and satisfaction in surgical patients. Although these have in the past been administered through written forms, there is increasing interest in the use of new technology to improve the efficiency of collection. The aim of this study was to assess the availability of internet access for a group of orthopaedic patients and the acceptability of online survey completion. Methods A total of 497 patients attending orthopaedic outpatient clinics were surveyed to assess access to the internet and their preferred means for completing follow-up questionnaires. Results Overall, 358 patients (72%) reported having internet access. Lack of access was associated with socioeconomic deprivation and older age. Multivariable regression confirmed increased age and greater deprivation to be independently associated with lack of internet access. Out of the total group, 198 (40%) indicated a preference for assessment of outcomes via email and the internet. Conclusions Internet access was not universal among the patients in our orthopaedic clinic. Reliance on internet collection of PROMs may introduce bias by not including results from patients in older age groups and those from the more deprived socioeconomic groups.

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“…The administration of electronic PRO surveys via email poses a unique set of obstacles to effective administration and high patient compliance, such as a lack of internet access, outdated email addresses, use of spam/junk mail folders, ease of dismissal, impersonal nature, and risk of survey fatigue. Jenkins et al 13 conducted an investigation in 2016 in which they surveyed 497 patients who presented to an orthopaedic outpatient clinic regarding their accessibility to the internet and preferred means for completing follow-up questionnaires. Interestingly, the authors found 72% of respondents to have internet access, and 40% indicated a preference for outcomes assessments to take place via email or the internet, while the remaining preferred a face-to-face evaluation or standard mail.…”