TY  - JOUR
AU  - Bevens, William
AU  - Weiland, Tracey
AU  - Gray, Kathleen
AU  - Jelinek, George
AU  - Neate, Sandra
AU  - Simpson-Yap, Steve
PY  - 2022
DA  - 2022/2/9
TI  - Attrition Within Digital Health Interventions for People With Multiple Sclerosis: Systematic Review and Meta-analysis
JO  - J Med Internet Res
SP  - e27735
VL  - 24
IS  - 2
KW  - digital health
KW  - meta-analysis
KW  - self-management
KW  - eHealth
KW  - attrition
KW  - digital health interventions
KW  - DHI
KW  - multiple sclerosis
KW  - MS
KW  - randomized controlled trials
AB  - Background: Digital health interventions have revolutionized multiple sclerosis (MS) care by supporting people with MS to better self-manage their disease. It is now understood that the technological elements that comprise this category of digital health interventions can influence participant engagement in self-management programs, and people with MS can experience significant barriers, influenced by these elements, to remaining engaged during a period of learning. It is essential to explore the influence of technological elements in mitigating attrition. Objective: This study aimed to examine the study design and technological elements of documented digital health interventions targeted at people with MS—digital health interventions that were intended to support a program of engagement over a defined period—and to explore how these correlated with attrition among participants of randomized controlled trials (RCTs). Methods: We conducted a systematic review and meta-analysis of RCTs (n=32) describing digital health self-management interventions for people with MS. We analyzed attrition in included studies, using a random-effects model and meta-regression to measure the association between potential moderators. Results: There were no measured differences in attrition between the intervention and control arms; however, some of the heterogeneity observed was explained by the composite technological element score. The pooled attrition rates for the intervention and control arms were 14.7% and 15.6%, respectively. Conclusions: This paper provides insight into the technological composition of digital health interventions designed for people with MS and describes the degree of attrition in both study arms. This paper will aid in the design of future studies in this area, particularly for digital health interventions of this type. 
SN  - 1438-8871
UR  - https://www.jmir.org/2022/2/e27735
UR  - https://doi.org/10.2196/27735
UR  - http://www.ncbi.nlm.nih.gov/pubmed/35138262
DO  - 10.2196/27735
ID  - info:doi/10.2196/27735
ER  -