Attrition in cognitive-behavioral treatment of chronic back pain.
OBJECTIVE
The aim of this study was to identify pretreatment factors associated with dropout from outpatient individualized cognitive-behavioral treatment for chronic back pain. Despite the importance of this issue, little is known about determinants of dropout from cognitive-behavioral treatment for chronic pain. The presented study is a subanalysis of a larger study on cognitive-behavioral treatment for chronic back pain.


METHODS
The study included 128 patients, who began a 25 session treatment. Three pretreatment domains (demographic variables, psychologic and pain-related symptom severity, and attitude toward treatment) and satisfaction with treatment within the first 3 sessions were considered as potential predictors of attrition.


RESULTS
Twenty-three patients (18%) were classified as dropouts. Low psychologic distress, low medication intake, and low treatment satisfaction were significantly associated with dropout. Other demographic variables, pain-related variables, attributions, and attitude toward treatment were not associated with treatment attrition. The associations were only valid for early dropouts.


CONCLUSIONS
It is concluded that cognitive-behavioral treatment of chronic pain should be adapted for less psychologically distressed patients to avoid treatment dropout.
Glombiewski
Julia Anna
JA
Philipps-University of Marburg, Section for Clinical Psychology and Psychotherapy, Gutenbergstr., Marburg, Germany. julia.glombiewski@staff.uni-marburg.de
Hartwich-Tersek
Jens
J
Rief
Winfried
W
D000328:Adult; D000704:Analysis of Variance; D001416:Back Pain / Q000523:psychology / Q000628:therapy*; D002908:Chronic Disease / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010352:Patient Dropouts; D017060:Patient Satisfaction; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D016312:Treatment Refusal