Overall and differential attrition in mindfulness-based interventions: A meta-analysis
Open accessAbstract
Objectives Attrition is very common in longitudinal research, including randomized controlled trials (RCTs) testing psychological interventions. Establishing rates and predictors of attrition in mindfulness-based interventions (MBIs) can assist clinical trialists and intervention developers. Differential attrition in RCTs that compared MBIs with structure and intensity matched active control conditions also provides an objective metric of relative treatment acceptability.Methods We aimed to evaluate rates and predictors of overall and differential attrition in RCTs of MBIs compared with matched active control conditions. Attrition was operationalized as loss to follow-up at post-test. Six online databases were searched.Results Across 114 studies (n = 11,288), weighted mean attrition rate was 19.1% (95% CI [.16, .22]) in MBIs and 18.6% ([.16, .21]) in control conditions. In the primary model, no significant difference was found in attrition between MBIs and controls (i.e., differential attrition; odds ratio [OR] = 1.05, [0.92, 1.19]). However, in sensitivity analyses with trim-and-fill adjustment, without outliers, and when using different estimation methods (Peto and Mantel-Haenszel), MBIs yielded slightly higher attrition (ORs = 1.10 to 1.25, p s < .050). Despite testing numerous moderators of overall and differential attrition, very few significant predictors emerged.Conclusions Results support efforts to increase the acceptability of MBIs, active controls, and/or RCTs, and highlight the possibility that for some individuals, MBIs may be less acceptable than alternative interventions. Further research including individual patient data meta-analysis is warranted to identify predictors of attrition and to characterize instances where MBIs may or may not be recommended. Meta-Analysis Review Registration: Open Science Framework (https://osf.io/c3u7a/).
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A previous meta-analysis reported that MBIs resulted in slightly higher attrition rates compared to control conditions in sensitivity analyses.
“This aligns with findings from a previous meta-analysis, which reported that MBIs resulted in slightly higher attrition rates compared to control conditions in sensitivity analyses (Lam et al., 2022).”
From Distress tolerance as a mediator of mindfulness-based intervention for anxiety and depression: Evidence from two randomized controlled trials (2024) · cites this paper as Lam et al., 2022
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Real-World Meditation App Engagement: Longitudinal Study of the Medito Meditation App
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- Authors
- Lam, S. U., Kirvin-Quamme, A., & Goldberg, S. B.
- Affiliations
- University of Wisconsin–Madison (US)
- Corresponding author
- Goldberg, Simon B.
- Venue
- Mindfulness
- Published
- 2022-09-09
- Volume
- 13
- Issue
- 11
- Pages
- 2676-2690
- ISSN
- 1868-8527 (ISSN-L)
- 1868-8535
- PMC
- PMC9728563
- OpenAlex
- W4295197014
- Cited by
- 39
- References
- 81
- Citations by year
- 2026: 9 · 2025: 19 · 2024: 6 · 2023: 5
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Mindfulness (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Complementary and Integrative Health (K23AT010879)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Keywords
- attrition, differential attrition, mindfulness-based interventions, loss to follow-up, active control, treatment acceptability, predictors of attrition, attrition rates, randomized controlled trials
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