Interim Analysis of Attrition Rates in Palliative Care Study on Dignity Therapy

Virginia Samuels, Tasha M. Schoppee, Amelia Greenlee, Destiny Gordon, Stacey Jean, Valandrea Smith, Tyra Reed, Sheri Kittelson, Tammie Quest, Sean O’Mahony, Josh Hauser, Marvin O.Delgado Guay, Michael W. Rabow, Linda Emanuel, George Fitchett, George Handzo, Harvey Max Chochinov, Yingwei Yao, Diana J. Wilkie*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


A routine threat to palliative care research is participants not completing studies. The purpose of this analysis was to quantify attrition rates mid-way through a palliative care study on Dignity Therapy and describe the reasons cited for attrition. Enrolled in the study were a total of 365 outpatients with cancer who were receiving outpatient specialty palliative care (mean age 66.7 ± 7.3 years, 56% female, 72% White, 22% Black, 6% other race/ethnicity). These participants completed an initial screening for cognitive status, performance status, physical distress, and spiritual distress. There were 76 eligible participants who did not complete the study (58% female, mean age 67.9 ± 7.3 years, 76% White, 17% Black, and 7% other race). Of those not completing the study, the average scores were 74.5 ± 11.7 on the Palliative Performance Scale and 28.3 ± 1.5 on the Mini-Mental Status Examination, whereas 22% had high spiritual distress scores and 45% had high physical distress scores. The most common reason for attrition was death/decline of health (47%), followed by patient withdrawal from the study (21%), and patient lost to follow-up (21%). The overall attrition rate was 24% and within the a priori projected attrition rate of 20%-30%. Considering the current historical context, this interim analysis is important because it will serve as baseline data on attrition prior to the outbreak of the COVID-19 pandemic. Future research will compare these results with attrition throughout the rest of the study, allowing analysis of the effect of the COVID-19 pandemic on the study attrition.

Original languageEnglish (US)
Pages (from-to)1503-1508
Number of pages6
JournalAmerican Journal of Hospice and Palliative Medicine
Issue number12
StatePublished - Dec 2021


  • attrition
  • cancer
  • dignity therapy
  • palliative care
  • spirituality

ASJC Scopus subject areas

  • General Medicine


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