Decreasing Reviewer Engagement Trends at Two STFM Journals

BACKGROUND AND OBJECTIVES: Securing peer reviewers for scholarly manuscripts is essential to journal operations but has become increasingly challenging. We sought to describe trends in acceptance of reviewer invitations and review completion at two journals sponsored by the Society of Teachers of Family Medicine: PRiMER and Family Medicine. METHODS: We conducted retrospective quality assurance of reviewer invitation outcomes for research manuscripts submitted to either journal from January 2010 to April 2026. Data were extracted from ScholarOne. We calculated odds ratios (ORs) for agreement to review and for review completion for each year via binary logistic regression, employing the generalized estimating equation to control for individual reviewer behavior, journal, and article type. RESULTS: We included 16,905 discrete invitations to review 2,574 manuscripts. Agreement rates at Family Medicine ranged from 70.99% in 2010, to a low of 41.80% in 2025, and 37.99% through April 2026; PRiMER agreement ranged from 74.36% in 2016, to 42.79% in 2025, and 20.23% in partial 2026. Combined completion rates dropped from 89.90% in 2010, to 82.20% in 2025, and to 73.90% in partial 2026. Using 2010 as the reference year, ORs for agreement to review dropped markedly, with the odds of accepting a review invitation in 2026 only 15.9% of the 2010 (2026: OR = 0.159, P<0.001) and the odds of review completion in 2026 falling to 32.9% of 2010 (OR = 0.329, P<0.001). CONCLUSIONS: Reviewer engagement is declining across both journals. New, innovative strategies to recruit, engage, and incentivize reviewers will be necessary to sustain peer review.