Design characteristics that influence attrition in geriatric antidepressant trials: meta‐analysis
Abstract
Objective: To identify study‐level and treatment group‐level characteristics that are associated with attrition in antidepressant trials for the depressed elderly. Methods: This meta‐analysis used 68 published antidepressant randomized trials for the elderly depressed. Study‐level and treatment group‐level variables were extracted. The former consisted of: use of placebo arm, number of arms, unbalanced treatment allocation, year conducted, study duration, study location, number of centers, and patient pool. The latter consisted of: assigned treatments, baseline mean Hamilton Depression Rating Scale (HDRS), baseline mean age, gender ratio, attrition size, and sample size. Univariate logistic regressions with attrition as the dependent variable were applied, followed by application of a forward stepwise selection method for identification of independent attrition correlates. Results: The 68 studies had a total of 153 treatment groups and 8,385 subjects. Among them, 2,287 subjects were terminated early, resulting in an overall 27.3% attrition rate. The stepwise results showed that higher attrition was significantly associated with active antidepressant groups as opposed to placebo groups, higher baseline HDRS, smaller sample size, unbalanced allocation of treatments, longer duration, and studies conducted in USA. Conclusions: The attrition in geriatric antidepressant trials can be affected by study and group‐level design characteristics that include severity of depression symptoms and active treatments among others. Copyright © 2009 John Wiley & Sons, Ltd.
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Most trials will have some degree of non-retention, and the number of off-study participants usually increases with the duration of follow-up.
“Most trials will have some degree of non-retention, and the number of these off-study participants usually increases with the duration of follow-up.394”
From SPIRIT 2025 explanation and elaboration: updated guideline for protocols of randomised trials (2025) · cites this paper as [394]
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- Authors
- Heo, M., Papademetriou, E., & Meyers, B. S.
- Affiliations
- Albert Einstein College of Medicine (US)
- Cornell University (US)
- Corresponding author
- Heo, Moonseong
- Venue
- International Journal of Geriatric Psychiatry
- Publisher
- Wiley
- Published
- 2009-03-04
- Volume
- 24
- Issue
- 9
- Pages
- 990-1001
- ISSN
- 0885-6230 (ISSN-L)
- 1099-1166
- OpenAlex
- W2048929476
- Cited by
- 18
- References
- 25
- Citations by year
- 2025: 2 · 2017: 1 · 2016: 1 · 2015: 3 · 2014: 2 · 2013: 3 · 2012: 2
- FWCI
- 1.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (P30MH068638, U01MH062518, U01MH62518)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- attrition, antidepressant trials, geriatric depression, trial design characteristics, sample size, baseline depression severity, Hamilton Depression Rating Scale, study duration
- MeSH terms
- Aged, Aged, 80 and over, Antidepressive Agents, Depressive Disorder, Female, Geriatrics, Humans, Male, Middle Aged, Patient Dropouts, Placebos, Randomized Controlled Trials as Topic
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