Attrition in trials evaluating complex interventions for schizophrenia: Systematic review and meta-analysis

J Psychiatr Res. 2017 Jul:90:67-77. doi: 10.1016/j.jpsychires.2017.02.009. Epub 2017 Feb 11.

Abstract

Essential criteria for the methodological quality and validity of randomized controlled trials are the drop-out rates from both the experimental intervention and the study as a whole. This systematic review and meta-analysis assessed these drop-out rates in non-pharmacological schizophrenia trials. A systematic literature search was used to identify relevant trials with ≥100 sample size and to extract the drop-out data. The rates of drop-out from the experimental intervention and study were calculated with meta-analysis of proportions. Meta-regression was applied to explore the association between the study and sample characteristics and the drop-out rates. 43 RCTs were found, with drop-out from intervention ranging from 0% to 63% and study drop-out ranging from 4% to 71%. Meta-analyses of proportions showed an overall drop-out rate of 14% (95% CI: 13-15%) at the experimental intervention level and 20% (95% CI: 17-24%) at the study level. Meta-regression showed that the active intervention drop-out rates were predicted by the number of intervention sessions. In non-pharmacological schizophrenia trials, drop-out rates of less than 20% can be achieved for both the study and the experimental intervention. A high heterogeneity of drop-out rates across studies shows that even lower rates are achievable.

Keywords: Attrition; Psychosis; Retention; Review; Schizophrenia; Treatment.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Antipyretics / therapeutic use*
  • Data Collection / statistics & numerical data*
  • Humans
  • Patient Dropouts / statistics & numerical data
  • Randomized Controlled Trials as Topic / methods*
  • Schizophrenia / therapy*

Substances

  • Antipyretics