The most common (>10% of all discontinuations) reasons for discontinuations in the first 6 months were subject decision (129, 38.1%), adverse event (56, 16.5%), lack of efficacy (41, 12.1%), and lost to follow-up (38, 11.2%).
Rocco and colleagues [ 42], in a matched controlled study of immunocompromised patients of different etiologies of acute respiratory failure, showed that patients receiving PSV with helmet had significantly lower NIV discontinuations in the first 24 hours than patients treated with mask; also, fewer complications related to device were reported (that is, skin necrosis, P = 0.01).
Overall a substantial proportion of treatment discontinuation in the first few months is due to adverse effects of medication [ 1].
Another study found less cART discontinuation in the first year among those with depressive disorder, but there was no association with cART persistence after the first year [ 120].
In the three subcohorts, rates of the treatment discontinuation in the first year ranged from 5.2%95%5% CI: 4.0 6.6) to 20.1% (95% CI: 16.2 24.2) in the AI 50 and in the Tam 40 groups, respectively.
The probability of discontinuation in the first cycle after treatment initiation and the respective probabilities of hypoglycaemic events, urinary tract infections and genital infections for each therapy are also outlined in Table 1.
Adverse events were the primary stated reason for discontinuation in the first 3 months but became a less frequent reason as the study progressed (46.0% of discontinuations in the period 0 to 3 months; 33.8% and 7.3% of discontinuations during the periods > 3 to 6 months and >6 to 12 months, respectively).
25 Analyses of discontinuation in the first 30-360 dafterfter myocardial infarction showed an association between discontinuation of vaginal oestrogen and a decreased risk of reinfarction (hazard ratio 0.54, 95% confidence interval 0.34 to 0.86), as well as an insignificant association for discontinuation of systemic oestrogen (0.56, 0.28 to 1.11) and overall HRT (0.90, 0.68 to 1.19) (table 3).
Only one study, which assessed cART persistence as the dependent variable, concluded that a severe mental disorder was significantly associated with lower probability for cART discontinuation in the first and second years (suggesting increased cART persistence), compared to participants with no mental disorders [ 120].
A confounder or combination of confounders that could decrease the risk of reinfarction from 1.00 to 0.54 for discontinuation in the first year after myocardial infarction would have to increase the risk fivefold (fig 3) and thereby exceed the effects of any measured confounder in the study, such as diabetes or age 80 or over.
