Article

The objectives were to provide an estimate of expected enrolment and
attrition rates based on published studies of existing self-management
interventions for people with multiple sclerosis, and to identify contributing
factors and impact on outcomes. REVIEW METHODS: A systematic literature search
was conducted using Ovid MEDLINE, PsychINFO, EMBASE, AMED, CINAHL, OT Seeker,
PubMed, and the Cochrane Database of Systematic Reviews databases. Controlled
trials with or without randomization using either a between-group or
within-person design were included if they met specified criteria. A
random-effect meta-regression analysis was conducted to estimate the overall
enrolment and attrition proportions, effect of person- and study-related factors,
and impact on outcomes. RESULTS: A total of 48 studies, comprising 4446 persons
were identified. The estimated enrolment rate was 50.3% (95% confidence interval
(CI): 49.6 to 51.1) and the estimated attrition rates in the intervention and
control groups were 16.8% (95% CI: 16.2 to 17.3) and 14.4% (95% CI: 13.8 to
14.9), respectively. The main reported reason for refusing to participate was
lack of interest (70.6%), while the reported reasons for dropping out were mainly
owing to medical issues (26.1%) and disliking the intervention (17.9%). Trial,
programme, and patient-related variables were found to influence the enrolment
and/or attrition rates. Studies that had a 10% higher attrition rate had an
effect size that was larger by 0.19 (95% CI: 0.17 to 0.24). CONCLUSION: Greater
understanding of the factors associated with enrolment and attrition rates would
help in planning and developing a more appealing self-management intervention
that patients can easily accept and incorporate into their everyday lives.

Langue : ANGLAIS