title: Factors associated with attrition from a randomized controlled trial of meaning-centered group psychotherapy for patients with advanced cancer.
abstract: OBJECTIVE
  The generalizability of palliative care intervention research is often limited by high rates of study attrition. This study examined factors associated with attrition from a randomized controlled trial comparing meaning-centered group psychotherapy (MCGP), an intervention designed to help advanced cancer patients sustain or enhance their sense of meaning to the supportive group psychotherapy (SGP), a standardized support group.
  
  
  METHODS
  Patients with advanced solid tumor cancers (n = 153) were randomized to eight sessions of either the MCGP or SGP. They completed assessments of psychosocial, spiritual, and physical well-being pretreatment, midtreatment, and 2 months post-treatment. Attrition was assessed in terms of the percent of participants who failed to complete these assessments, and demographic, psychiatric, medical, and study-related correlates of attrition were examined for the participants in each of these categories.
  
  
  RESULTS
  The rates of attrition at these time points were 28.1%, 17.7%, and 11.1%, respectively; 43.1% of the participants (66 of 153) completed the entire study. The most common reason for dropout was patients feeling too ill. Attrition rates did not vary significantly between study arms. The participants who dropped out pretreatment reported less financial concerns than post-treatment dropouts, and the participants who dropped out of the study midtreatment had poorer physical health than treatment completers. There were no other significant associations between attrition and any demographic, medical, psychiatric, or study-related variables.
  
  
  CONCLUSIONS
  These findings highlight the challenge of maintaining advanced cancer patients in longitudinal research and suggest the need to consider alternative approaches (e.g., telemedicine) for patients who might benefit from group interventions but are too ill to travel.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, NY, USA. applebaa@mskcc.org.
authors.forename: Allison J
authors.initials: AJ
authors.lastname: Applebaum
authors.forename: Wendy G
authors.initials: WG
authors.lastname: Lichtenthal
authors.forename: Hayley A
authors.initials: HA
authors.lastname: Pessin
authors.forename: Julia N
authors.initials: JN
authors.lastname: Radomski
authors.forename: N
authors.initials: N
authors.lastname: Simay Gökbayrak
authors.forename: Aviva M
authors.initials: AM
authors.lastname: Katz
authors.forename: Barry
authors.initials: B
authors.lastname: Rosenfeld
authors.forename: William
authors.initials: W
authors.lastname: Breitbart
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D009519:New York City; D010166:Palliative Care / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D010352:Patient Dropouts; D011615:Psychotherapy, Group / Q000379:methods*; D011788:Quality of Life / Q000523:psychology; D012657:Self-Help Groups; D012720:Severity of Illness Index; D013727:Terminal Care / Q000379:methods; D019452:Terminally Ill / Q000523:psychology*; D016896:Treatment Outcome