title: Prevalence and predictors of treatment dropout from physical activity interventions in schizophrenia: a meta-analysis.
abstract: OBJECTIVE
  Physical activity interventions have been shown to improve the health of people with schizophrenia, yet treatment dropout poses an important challenge in this population, and rates vary substantially across studies. We conducted a meta-analysis to investigate the prevalence and predictors of treatment dropout in physical activity interventions in people with schizophrenia.
  
  
  METHODS
  We systematically searched major electronic databases from inception until August 2015. Randomized controlled trials of physical activity interventions in people with schizophrenia reporting dropout rates were included. Two independent authors conducted searches and extracted data. Random-effects meta-analysis and meta-regression analyses were conducted.
  
  
  RESULTS
  In 19 studies, 594 patients with schizophrenia assigned to exercise interventions were investigated (age=37.2 years, 67.5% male, range=37.5%-100%). Trim and fill adjusted treatment dropout rate was 26.7% [95% confidence interval (CI)=19.7%-35.0%], which is more than double than in nonactive control interventions (odds ratio=2.15, 95% CI=1.29-3.58, P=.003). In the multivariate regression, qualification of the professional delivering the intervention (β=-1.06, 95% CI=-1.77 to -0.35, P=.003) moderated treatment dropout rates, while continuous supervision of physical activity approached statistical significance (P=.05).
  
  
  CONCLUSIONS
  Qualified professionals (e.g., physical therapists/exercise physiologists) should prescribe supervised physical activity for people with schizophrenia to enhance adherence, improve psychiatric symptoms and reduce the onset and burden of cardiovascular disease.
authors.affiliation: KU Leuven-University of Leuven Department of Rehabilitation Sciences, Tervuursevest 101, Leuven, Belgium; KU Leuven-University of Leuven, Z.org Leuven, campus Kortenberg, Leuvensesteenweg 517, Kortenberg, Belgium. Electronic address: Davy.Vancampfort@uc-kortenberg.be.
authors.forename: Davy
authors.initials: D
authors.lastname: Vancampfort
authors.affiliation: School of Psychiatry, University of New South Wales, Liverpool NSW 2170, Sydney, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Rosenbaum
authors.affiliation: Hospital de Clinicas de Porto Alegre, R. Ramiro Barcelos, 2350-Santa Cecilia, Porto Alegre, Brazil; Programa de Pós Graduação em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Felipe B
authors.initials: FB
authors.lastname: Schuch
authors.affiliation: School of Psychiatry, University of New South Wales, Liverpool NSW 2170, Sydney, Australia.
authors.forename: Philip B
authors.initials: PB
authors.lastname: Ward
authors.affiliation: KU Leuven-University of Leuven Department of Rehabilitation Sciences, Tervuursevest 101, Leuven, Belgium.
authors.forename: Michel
authors.initials: M
authors.lastname: Probst
authors.affiliation: Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D012559:Schizophrenia / Q000534:rehabilitation*
keywords: Health service; Physical activity; Physical exercise; Psychosis; Schizophrenia