Table 1 Summary of studies and study characteristics included in the review (in chronological order)
Study | Country | Aims | Definition of dropout | Sample | Method | Treatment setting | Quality assessment rating |
|---|---|---|---|---|---|---|---|
Merrill et al. [40] | USA | Compare the characteristics of those who dropout and those who do not in patients with BN receiving group therapy | Dropping out before 20 weeks of completed group therapy | n = 17 Gender: N/R Age range: 18–48 Diagnoses: BN Dropout from: Group therapy Ethnicity: Asian = 1, Caucasian = 16 Education level: N/R | Questionnaire assessing dropout reasons with an open-ended question. No further clarification of analysis methods offered | Outpatient | Medium |
Eivors et al. [32] | United Kingdom | Understand the meaning of dropout from services for patients with AN | Unilateral decision to dropout made by the patient | n = 8 Gender: Women Age range: 21–43 Diagnoses: AN, Partial syndrome AN Dropout from: Specialist adult ED service—outpatient or inpatient Ethnicity: N/R Education level: N/R | Semi-structured interview, written autobiographical account Grounded theory | Participants were treated by a multi-disciplinary outpatient treatment team, with two also treated as inpatients | High |
Darcy et al. [36] | USA | Explore how individuals with AN engage in treatment and describe recovery | Non-compliance or treatment failure | n = 20 Gender: Women Age range: 19–52 Diagnoses: AN Dropout from: Any ED treatment Ethnicity: Biracial = 3, Caucasian = 17 Education level: N/R | Semi-structured interview with open-ended and probe questions, focus groups, self-report questionnaire Thematic analysis | Treatment was reported by participants as a mix of outpatient and inpatient treatment | High |
Vandereycken and Devidt [39] | Belgium | To gain a greater understanding of the meaning dropout from ED therapy from staff and patients | Cessation of treatment in contradiction of the treatment agreement or a unilateral decision to dropout made by the patient | n = 19 Gender: Female Age range: 15–35 Diagnoses: AN-R (n = 7), AN-BP (n = 3), BN (n = 6), EDNOS (n = 5) Dropout from: Specialist ED inpatient setting Ethnicity: N/R Education level: N/R | Self-report questionnaire, written autobiographical statements from patients Descriptive statistics and written presentation of the qualitative results | Inpatient | Low |
Leavey et al. [33] | United Kingdom | Understand the reasons behind non-engagement at a specialist ED unit | Failure to attend first appointment or attended once then dropped out | n = 13 Gender: Women (n = 12), men (n = 1) Age range: N/R Diagnoses: AN, BN, BED Dropout from: GP referral for specialist ED service Ethnicity: Black Caribbean = 1, Black European = 1, Jewish = 1, Turkish Cypriot = 1, White and Asian = 1, White British = 7, White Irish = 1 Education level: N/R | Interview (type and structure not specified) Interpretative phenomenological analysis | Outpatient | High |
Seidinger-Leibovitz et al. [34] | Brazil | Explore the meaning of dropout in an outpatient ED setting using qualitative methods | Unilateral decision to dropout made by the patient after attending at least one month of treatment | n = 8 Gender: Women Age range: 18–30 Diagnoses: AN-R, AN-P, BN, EDNOS Dropout from: Outpatient ED service Ethnicity: N/R Education level: Graduate = 3, High School = 2, Vocational School = 1, Incomplete High School = 2 | Semi-structured interview Thematic analysis using a psychodynamic theoretical framework | Outpatient | High |
ter Huurne et al. [31] | Netherlands | Explore reasons for dropout, predictive factors of dropout and investigate the overall patient experience of the treatment of a web-based ED treatment | Did not begin the programme or terminated their attendance during treatment | n = 53 Gender: Women Age range: 38.1 ± 12.4 Diagnoses: BN, BED, EDNOS Dropout from: Web-based CBT Ethnicity: N/R Education level: N/R for interviews | Online self-report questionnaire including open-ended question exploring reasons for dropout Descriptive percentages of the qualitative data | Web-based Cognitive Behavioural Therapy | Low |
Frostad et al. [38] | Norway | Measure BMI changes in a group of patients with AN receiving a CBT-E intervention | Not starting or dropping out before completing 12 months of a CBT-E programme | n = 22 Gender: Women (n = 21), men (n = 1) Age range: 21.1 ± 4.2 Diagnoses: AN Dropout from: CBT-E Ethnicity: N/R Education level: N/R | Reasons for dropout assessed in detail with therapist and documented Descriptive presentation of the qualitative data | Online | Medium |
del Barrio et al. [37] | Spain | Investigate the rate and personal characteristics associated with dropping out from treatment at a 2-year follow-up in a sample of patients diagnosed with an ED | Nonconsensual interruption of treatment ensuing from the patient’s own decision | n = 58 Gender: Mixed, n per gender unspecified Mean age: 28.3 (SD = 9.67) Diagnoses: AN, BN, EDNOS Dropout from: Specialist ED unit, including outpatient therapy Ethnicity: Cauasian = 54, Hispanic = 3, Romani = 1 Education level: N/R | Longitudinal prospective cohort follow-up study, close-ended questionnaire, semi-structured telephone interview Descriptive percentages of the qualitative data | Inpatient | Medium |
Bakland et al. [35] | Norway | Investigate the experiences of those who dropped out from a novel specialised ED treatment | Non-completion of less than 80% of the treatment programme | n = 5 Gender: Women Age range: 21–41 Diagnoses: BN (n = 3), BED (n = 2) Dropout from: Combined group therapy, exercise and diet programme Ethnicity: N/R Education level: N/R | Open-ended interview Hermeneutical phenomenology, interpretation theory | Outpatient | High |