Interim Analysis of Attrition Rates in Palliative Care Study on Dignity Therapy. (December 2021)

• Record Type: Journal Article
• Authors: Samuels, Virginia; Schoppee, Tasha M.; Greenlee, Amelia; Gordon, Destiny; Jean, Stacey; Smith, Valandrea; Reed, Tyra; Kittelson, Sheri; Quest, Tammie; O'Mahony, Sean; Hauser, Josh; Guay, Marvin O. Delgado; Rabow, Michael W.; Emanuel, Linda; Fitchett, George; Handzo, George; Chochinov, Harvey Max; Yao, Yingwei; Wilkie, Diana J.
• Is Part Of: American journal of hospice & palliative care. Volume 38:Number 12(2021)
• Page Start: 1503
• Page End: 1508
• Publication Date: 2021-12
• Subjects: attrition -- spirituality -- cancer -- palliative care -- dignity therapy; Hospice care -- Periodicals; Palliative treatment -- Periodicals; 362.175
• DOI: 10.1177/1049909121994309
• Languages: English
• ISSNs: 1049-9091

Abstract

A routine threat to palliative care research is participants not completing studies. The purpose of this analysis was to quantify attrition rates mid-way through a palliative care study on Dignity Therapy and describe the reasons cited for attrition. Enrolled in the study were a total of 365 outpatients with cancer who were receiving outpatient specialty palliative care (mean age 66.7 ± 7.3 years, 56% female, 72% White, 22% Black, 6% other race/ethnicity). These participants completed an initial screening for cognitive status, performance status, physical distress, and spiritual distress. There were 76 eligible participants who did not complete the study (58% female, mean age 67.9 ± 7.3 years, 76% White, 17% Black, and 7% other race). Of those not completing the study, the average scores were 74.5 ± 11.7 on the Palliative Performance Scale and 28.3 ± 1.5 on the Mini-Mental Status Examination, whereas 22% had high spiritual distress scores and 45% had high physical distress scores. The most common reason for attrition was death/decline of health (47%), followed by patient withdrawal from the study (21%), and patient lost to follow-up (21%). The overall attrition rate was 24% and within the a priori projected attrition rate of 20%-30%. Considering the current historical context, this interim analysis is important because it will serve as baseline data on attrition prior to the outbreak of the COVID-19 pandemic. Future research will compare these results with attrition throughout the rest of the study, allowing analysis of the effect of the COVID-19 pandemic on the study attrition.