Exploring dropout in internet-delivered cognitive behavioral therapy for insomnia: A secondary analysis of prevalence, self-reported reasons, and baseline and intervention data as predictors
Abstract
Introduction Internet-delivered cognitive behavioral therapy for insomnia (iCBT-I) is an effective treatment. However, dropout is a common challenge in digital therapeutics. This study examines dropout in iCBT-I by analyzing reported reasons for dropout and investigating whether baseline variables and intervention usage data can predict dropout. Methods This is an exploratory secondary analysis of a clinical trial investigating a stepped care model for insomnia featuring an eight-module iCBT-I. Reasons for dropout from the iCBT-I were assessed via self-developed items in follow-up surveys, and a dropout survey was sent to all patients who had not completed at least seven modules of the iCBT-I within 12 weeks. The proportion of respondents who agreed with the respective items was calculated. Additionally, bivariate models were specified to explore whether baseline variables and intervention usage data can predict dropout. Results The patients included in this sub-study had a mean age of 49.3 (SD=13.0), with 73.4 % identifying as female. At pre-treatment, their mean insomnia severity was 18.6 (SD=3.9). Among the 233 patients, 103 (44.2 %) were categorized as dropouts. The most frequently reported reasons for dropout were distractions from daily life, the perception of the content not being useful, and difficulties resuming after a break. None of the examined baseline variables significantly predicted dropout, whereas the time needed to complete the first module (OR=1.16; 95…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 233 participants or records.
Read the paper
Related studies
- Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials
- Tocilizumab in patients with severe COVID-19: a retrospective cohort study
- A new aging measure captures morbidity and mortality risk across diverse subpopulations from NHANES IV: A cohort study
- Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study
- Are noise and air pollution related to the incidence of dementia? A cohort study in London, England
- Long COVID symptoms and duration in SARS-CoV-2 positive children — a nationwide cohort study
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.