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Rates of Attrition and Dropout in App-Based Interventions for Chronic Disease: Systematic Review and Meta-Analysis
Gideon Meyerowitz-Katz1,2, Sumathy Ravi1, Leonard Arnolda2,3
1Western Sydney Diabetes, Western Sydney Local Health District, Blacktown NSW, Australia.
Journal of Medical Internet Research
|September 29, 2020
Summary
Mobile health app use for chronic disease management has a high dropout rate of 43%. Addressing social, demographic, and behavioral factors can improve long-term patient engagement and intervention effectiveness.
Area of Science:
- Digital Health
- Health Services Research
- Chronic Disease Management
Background:
- Chronic diseases pose a significant global health burden.
- App-based interventions are used to manage chronic diseases, but suffer from high attrition rates.
- Sustained use of health apps is a challenge, with many users dropping off quickly.
Purpose of the Study:
- To systematically review and meta-analyze dropout rates in app-based chronic disease interventions.
- To qualitatively explore reasons for attrition in mobile health (mHealth) interventions.
- To identify strategies for improving long-term patient adherence to digital health tools.
Main Methods:
- Searched MEDLINE, PubMed, Cochrane CENTRAL, and Embase for studies on mHealth and attrition.
- Included randomized controlled trials (RCTs) and observational studies measuring dropout in chronic disease management.
- Conducted a meta-analysis of attrition rates and qualitative synthesis of dropout reasons.
Main Results:
- 17 studies were included, with a pooled dropout rate of 43% (95% CI 29-57).
- Observational studies showed higher dropout rates (49%) than RCTs (40%).
- Qualitative synthesis identified social, demographic, and behavioral factors contributing to attrition.
Conclusions:
- Attrition rates in mHealth interventions for chronic disease are substantial.
- Addressing identified factors can potentially minimize dropout.
- Reducing dropout is crucial for enhancing the long-term effectiveness of these digital health tools.
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