Overall and Differential Attrition in Mindfulness-Based Interventions: A Meta-Analysis
Sin U Lam1,2, Andrew Kirvin-Quamme2, Simon B Goldberg1,2
1Department of Counseling Psychology, University of Wisconsin-Madison, Madison, WI, USA.
Mindfulness
|December 12, 2022
Summary
Attrition rates in mindfulness-based interventions (MBIs) are similar to active controls. However, some analyses suggest slightly higher attrition in MBIs, indicating potential differences in acceptability for certain individuals.
Area of Science:
- Psychology
- Clinical Trials
- Intervention Science
Background:
- Attrition is a significant challenge in longitudinal research, particularly in randomized controlled trials (RCTs) for psychological interventions.
- Understanding attrition in mindfulness-based interventions (MBIs) is crucial for improving clinical trial design and intervention development.
- Differential attrition in RCTs comparing MBIs with matched active controls offers insights into treatment acceptability.
Purpose of the Study:
- To evaluate overall and differential attrition rates in RCTs of MBIs compared to matched active control conditions.
- To identify predictors of attrition in MBIs and active controls within RCTs.
- To assess the relative acceptability of MBIs versus active controls based on attrition patterns.
Main Methods:
- A systematic search of six online databases was conducted.
- Meta-analysis of 114 studies involving 11,288 participants was performed.
- Attrition was defined as loss to follow-up at post-test; differential attrition was analyzed.
Main Results:
- The weighted mean attrition rate was 19.1% for MBIs and 18.6% for control conditions across 114 studies.
- Primary analysis showed no significant difference in attrition between MBIs and controls (OR = 1.05).
- Sensitivity analyses indicated slightly higher attrition for MBIs (ORs = 1.10–1.25) under certain adjustments, with few significant predictors identified.
Conclusions:
- Findings suggest that while overall attrition is comparable, MBIs might be less acceptable than some alternative interventions for certain individuals.
- Efforts to enhance the acceptability of MBIs, active controls, and RCTs are supported.
- Further individual patient data meta-analyses are needed to identify specific attrition predictors and guide MBI recommendations.
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