- Title
- Dropout from guideline-recommended psychological treatments for posttraumatic stress disorder: A systematic review and meta-analysis
- Creator
- Varker, Tracey; Jones, Kimberley A.; McFarlane, Alexander; Hopwood, Malcolm; O'Donnell, Meaghan; Arjmand, Hussain-Abdulah; Hinton, Mark; Hiles, Sarah A.; Freijah, Isabella; Forbes, David; Kartal, Dzenana; Phelps, Andrea; Bryant, Richard A.
- Relation
- Journal of Affective Disorders Reports Vol. 4, Issue April 2021, no. 100093
- Publisher Link
- http://dx.doi.org/10.1016/j.jadr.2021.100093
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2021
- Description
- Background: Many patients drop out of guideline-recommended treatments for posttraumatic stress disorder (PTSD), yet there has been little systematic investigation of this issue. We aimed to examine dropout proportions from randomized controlled trials (RCTs) of guideline-recommended treatments for PTSD and whether proportions differed by type of treatment or trauma, PTSD severity or chronicity, or medication being permitted. Methods: Systematic review and meta-analysis of RCTs of guideline-recommended treatments for PTSD. Results: Eighty-five trials, with data for 6804 participants were included in the meta-analyses. The mean dropout proportion for guideline-recommended treatment was 20.9% (95%CI 17.2, 24.9) with evidence of high heterogeneity across studies. Military trauma was associated with higher dropout than civilian trauma. The civilian trauma group had similar dropout rates from guideline-recommended treatments, and active, waitlist or treatment as usual controls. In the military trauma group, dropout was higher from guideline-recommended treatments compared to active, waitlist or treatment as usual controls. Within this group, dropout from trauma-focused treatment was significantly higher than from non-trauma focused treatments overall, with the greatest difference in dropout rates occurring between randomization and treatment initiation. Limitations: Most RCTs exclude participants who have comorbid substance use disorder, suicidal behaviour, or history of psychosis, which limits the generalizability of findings. Conclusion: Dropout from guideline-recommended treatment for PTSD is higher in populations who have experienced military trauma and this population dropout from treatment in higher proportions when it is trauma-focused. The reasons for disparate rates of dropouts from recommended PTSD treatments require further investigation.
- Subject
- dropout; PTSD; guidelines; treatment; meta-analysis; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1437209
- Identifier
- uon:40274
- Identifier
- ISSN:2666-9153
- Language
- eng
- Reviewed
- Hits: 2875
- Visitors: 2874
- Downloads: 0