Attrition in Randomized Controlled Trials for Pediatric Chronic Conditions

• Published in: Journal of pediatric psychology Vol. 34; no. 7; pp. 782 - 793
• Main Authors: Karlson, Cynthia W., Rapoff, Michael A.
• Format: Journal Article
• Language: English
• Published: Atlanta, GA Oxford University Press 01.08.2009
• Subjects: Analysis of Variance; attrition; Behavior therapy. Cognitive therapy; Biological and medical sciences; Child; Child clinical studies; Chronic Disease - therapy; chronic illness; cognitive behavioral intervention; Cognitive Therapy - methods; Cognitive Therapy - statistics & numerical data; Follow-Up Studies; Humans; Medical sciences; Patient Selection; pediatric; Pediatrics - statistics & numerical data; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; randomized controlled trial; Randomized Controlled Trials as Topic - methods; Randomized Controlled Trials as Topic - statistics & numerical data; Research Subjects; Treatments; cognitive behavioral intervention; attrition; chronic illness; pediatric; randomized controlled trial; Human; Pediatrics; Cognitive therapy; Chronic disease; Controlled therapeutic trial; Attrition; Chronic; Treatment; Behavior therapy; Child
• ISSN: 0146-8693; 1465-735X; 1465-735X
• DOI: 10.1093/jpepsy/jsn122

Objective To examine attrition variables in randomized controlled trials of cognitive behavioral interventions for children with chronic illnesses. Methods We examined attrition rates reported on 40 randomized cognitive behavioral interventions published in six pediatric research journals, during the years 2002–2007. Intervention focus was limited to children with a chronic medical condition, such as asthma, obesity, arthritis, diabetes, cancer, sickle cell disease, and cystic fibrosis. Results Mean rate of enrollment refusal was 37% (range 0–75%). Mean attrition rate was 20% (range 0–54%) for initial follow-up and 32% (range 0–59%) for extended follow-up. Of the reviewed articles, 40% included a CONSORT diagram. Conclusions Strategies that can be used to limit attrition include tailoring recruitment to the study population, providing personalized feedback, maintaining consistent study procedures, providing incentives, and using intensive tracking measures. There is a need for standardized definitions and reporting of attrition rates in randomized cognitive behavioral intervention studies.