Prevalence and predictors of treatment dropout from physical activity interventions in schizophrenia: a meta-analysis

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• 作者：Davy Vancampfort ; Ph.D.^a ; ^b ; ^{Davy.Vancampfort@uc-kortenberg.be" class="auth_mail" title="E-mail the corresponding author} ; Simon Rosenbaum ; Ph.D.^c ; Felipe B. Schuch ; Ph.D.^d ; ^e ; Philip B. Ward ; Ph.D.^c ; Michel Probst ; Ph.D.^a ; Brendon Stubbs ; Ph.D.^f ; ^g
• 关键词：Schizophrenia ; Psychosis ; Physical activity ; Physical exercise ; Health service
• 刊名：General Hospital Psychiatry
• 出版年：2016
• 出版时间：March-April 2016
• 年：2016
• 卷：39
• 期：Complete
• 页码：15-23
• 全文大小：368 K

文摘

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.

Method

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.