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RESEARCH PRODUCT
Dropout from exercise randomized controlled trials among people with depression: A meta-analysis and meta regression
Felipe Barreto SchuchSimon RosenbaumMarco SolmiNicola VeroneseAndrew SoundyJustin RichardsPhilip B. WardDavy VancampfortBrendon StubbsBrendon Stubbssubject
medicine.medical_specialtyPatient DropoutseducationDepression Exercise Physical activity DropoutPsychological interventionlaw.inventionRandomized controlled triallawPrevalencemedicineHumansMeta-regressionExerciseDepression (differential diagnoses)Dropout (neural networks)Randomized Controlled Trials as TopicDepressive Disorder MajorDepressive DisorderDepressionPhysical activityDropoutMajormedicine.diseaseExercise TherapyPsychiatry and Mental healthClinical PsychologyMeta-analysisPhysical therapyMajor depressive disorderDepression; Dropout; Exercise; Physical activity; Depression; Depressive Disorder Major; Humans; Patient Dropouts; Prevalence; Randomized Controlled Trials as Topic; Exercise Therapy; Psychiatry and Mental Health; Clinical PsychologyExercise prescriptionPsychologydescription
Abstract Objective Exercise has established efficacy in improving depressive symptoms. Dropouts from randomized controlled trials (RCT’s) pose a threat to the validity of this evidence base, with dropout rates varying across studies. We conducted a systematic review and meta-analysis to investigate the prevalence and predictors of dropout rates among adults with depression participating in exercise RCT’s. Method Three authors identified RCT’s from a recent Cochrane review and conducted updated searches of major electronic databases from 01/2013 to 08/2015. We included RCT’s of exercise interventions in people with depression (including major depressive disorder (MDD) and depressive symptoms) that reported dropout rates. A random effects meta-analysis and meta regression were conducted. Results Overall, 40 RCT’s were included reporting dropout rates across 52 exercise interventions including 1720 people with depression (49.1 years (range=19–76 years), 72% female (range=0–100)). The trim and fill adjusted prevalence of dropout across all studies was 18.1% (95%CI=15.0–21.8%) and 17.2% (95%CI=13.5–21.7, N =31) in MDD only. In MDD participants, higher baseline depressive symptoms ( β= 0.0409, 95%CI=0.0809–0.0009, P =0.04) predicted greater dropout, whilst supervised interventions delivered by physiotherapists ( β =−1.2029, 95%CI=−2.0967 to −0.3091, p =0.008) and exercise physiologists ( β= −1.3396, 95%CI=−2.4478 to −0.2313, p =0.01) predicted lower dropout. A comparative meta-analysis ( N =29) established dropout was lower in exercise than control conditions (OR=0.642, 95%CI=0.43–0.95, p =0.02). Conclusions Exercise is well tolerated by people with depression and drop out in RCT’s is lower than control conditions. Thus, exercise is a feasible treatment, in particular when delivered by healthcare professionals with specific training in exercise prescription.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2015-09-02 |