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Risk Factors for Noninitiation and Dropout in Blended Therapy in Inpatient Psychiatric Patients: Retrospective Cohort
Nikita Gupta1, Fabian Gardin1, Thomas Berger2
1Clienia AG, Oetwil am See, Switzerland.
JMIR Human Factors
|June 29, 2026
Summary
Blended therapy (BT) uptake was low among inpatients. Older age reduced noninitiation, while anxiety disorders decreased dropout, suggesting targeted support for digital mental health tools.
Area of Science:
- Psychiatry
- Digital Health
- Mental Healthcare
Background:
- Blended therapy (BT) integrates digital tools with in-person psychiatric care, showing comparable or superior outcomes to traditional therapy.
- Despite its benefits, BT implementation faces challenges, with many inpatients struggling to initiate or sustain engagement with digital components.
- Understanding factors influencing BT noninitiation and dropout is crucial for optimizing its integration into psychiatric settings.
Purpose of the Study:
- To investigate sociodemographic variables, comorbidities, and symptom severity influencing BT noninitiation and dropout in psychiatric inpatients.
- To identify predictors of engagement with a digital mental health platform within an inpatient setting.
Main Methods:
- A multicentric, retrospective observational study analyzed data from 278 inpatients offered BT via the Minddistrict platform.
- Multivariable logistic regression models identified predictors of noninitiation and dropout.
- The study period was January 2020 to May 2024, with a sample primarily diagnosed with depression and PTSD.
Main Results:
- Only 1.8% of patients completed all assigned BT modules; one-third did not initiate the platform.
- Increasing age was associated with lower noninitiation (OR 0.98, P=.01).
- Comorbid anxiety disorders were linked to a reduced risk of dropout (OR 0.23, P=.007).
Conclusions:
- BT uptake was limited in this selected inpatient sample.
- Older age predicts lower noninitiation, and comorbid anxiety predicts lower dropout.
- Findings inform strategies for enhancing BT support in inpatient psychiatric care, acknowledging therapist-selected access.
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