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Patient adherence to cognitive behavioural therapy for obsessive-compulsive disorder: a systematic review and meta-analysis
journal contribution
posted on 2023-06-09, 20:26 authored by Tamara Leeuwerik, Kate CavanaghKate Cavanagh, Clara StraussClara StraussWhilst cognitive behavioural therapy (CBT) is the treatment of choice for obsessive-compulsive disorder (OCD), around half of the participants do not experience remission following treatment. As yet, there is no comprehensive systematic review of the extent to which patient non-adherence presents a challenge to the overall benefit of CBT for OCD. The aim of this systematic review and meta-analysis was to identify the magnitude, moderators and reasons for poor patient adherence to CBT for OCD in terms of: (1) treatment refusal, (2) treatment dropout, (3) session attendance/module completion, and (4) between-session CBT task adherence. Sociodemographic and clinical variables, treatment and study design characteristics were examined as moderators of adherence. The systematic search identified 123 studies including 5627 participants taking part in CBT or control conditions. A pooled rate of 15.6% of eligible patients refused CBT and a further 15.9% of treatment starters dropped out from treatment. Group CBT had significantly lower dropout rates than individually-delivered CBT. No other significant moderators were found. Most studies reported moderate to good adherence to between-session CBT tasks, which had a significant medium to large association with post-treatment OCD symptom reduction. Recommendations for enhanced measurement and reporting of patient adherence to CBT for OCD are made along with clinical implications of findings.
History
Publication status
- Published
Journal
Journal of Anxiety DisordersISSN
0887-6185Publisher
ElsevierExternal DOI
Volume
68Article number
a102135Department affiliated with
- Psychology Publications
Full text available
- No
Peer reviewed?
- Yes
Legacy Posted Date
2020-01-29Usage metrics
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