Enrollment, adherence and retention rates among musculoskeletal disorders rehabilitation practitioners in knowledge translation studies: a systematic review and meta-regression

Abstract

Background Practitioners’ enrollment, adherence, and retention rates influence estimates of effectiveness in knowledge translation (KT) studies and remain important concerns for implementation researchers. This review aimed to systematically summarize the current evidence on feasibility measures as gauged by enrollment, adherence, and retention rates in KT evaluation studies targeting rehabilitation practitioners treating musculoskeletal disorders (MSDs). Methods We searched five electronic databases from the inception to October 2022. We included KT studies that 1) had designs recommended by the Effective Practice and Organisation of Care, 2) targeted rehabilitation practitioners managing patients with MSDs, 3) delivered KT interventions according to the Expert Recommendations for Implementing Change classification, and 4) reported on the feasibility measures (e.g., enrollment, adherence, and retention). Descriptive statistics were conducted to report on study-, practitioners- and intervention-related factors influencing enrollment, adherence, and retention rates. Meta-regression weighted by the sample size of included studies was used to estimate the effect of factors on overall enrollment, adherence, and retention rates. Results Findings from 33 KT studies reported weighted enrolment, adherence, and retention rate of 82% (range: 32%-100%), 74% (range: 44%-100%), and 65% (range: 36%-100%) respectively for both intervention and control groups. Factors positively influencing enrollment, adherence, and retention rates included designing short study period with short duration intervention. Conclusions Intense (e.g., high frequency, short duration) single KT intervention was more appealing for practitioners. Future evaluation studies should clearly report follow-up data, and practitioners’ prior training, Results may not apply to non-MSD healthcare providers.