Patient-perceived barriers and enablers to adherence to physiotherapist prescribed self-management strategies

Abstract

The objectives of this study were to describe patient-reported adherence to physiotherapist-prescribed self-management strategies; and the perceived barriers and enablers to adherence to each strategy. Patients attending physiotherapy private practices (n=4) were observed during their consultation. Patients prescribed one or more self-management strategies received a follow-up telephone interview within 10-14 days of the observed consultation and were asked to self-report their level of adherence and their perceived barriers and/or enablers to each prescribed strategy. Results indicated that patients (n=108) reported receiving 177 strategies and being fully adherent to 36% (95% CI: 29-44%) of these strategies. Patient-reported adherence barriers (n=113) and enablers (n=172) were coded using a modified version of the World Health Organisation five dimensions of adherence. Frequently reported barriers included social/economic-related (n=52; 46%) such as being too busy, and patient-related (n=29; 26%) including being too tired/lack of motivation. Frequently reported enablers included therapy-related (n=71; 41%) such as "the strategy was easy to complete", and condition-related (n=45; 26%) including "that the strategy helped to manage symptoms". Thus, patient adherence may be aided by ensuring that: the strategy is less complex; it does not cause pain; it isn't time consuming; and it leads to an improvement in condition-related symptoms.

Some Aspects of the Potential Adherence to Rehabilitation of Patients With Musculoskeletal Injuries

“…When analysing the answers to the question about understanding the importance of rehabilitation, it was found that the interviewed patients with injuries understand the importance of rehabilitation treatment and do not want to experience limitations, but admit that they will find it difficult to tolerate pain and discomfort during rehabilitation. According to research, pain is often the reason of reduced commitment to rehabilitation [8,10,11]. But at the same time quite a large proportion of our respondents said that they will perform the prescribed exercises, despite the inconvenience.…”

“…It should be considered that the performance of exercises at home is influenced by reduced attachment [12][13][14][15]. Before prescribing such exercises, it is necessary to provide the necessary comprehensive information, as it has been proven that this can have a decisive impact on patients` performance [10]. WHO identifies "Social and economic factors", where an important role is played by the financial security of the population, as one of the five groups of factors influencing adherence to treatment [2].…”

Wrangling Diabetes: Illuminating the Latent Processes That Impact Diabetes Self-Management Behaviors

“…15 Various barriers to realized outcomes have been explored. For example, Peek et al 16 categorized self-management barriers according to the World Health Organization's 5 dimensions of adherence and found that their study population's barriers included being too busy, strategy was not convenient, did not feel well enough to engage in the strategy, or were too tired/unmotivated. Other researchers have noted that scheduling conflicts, self-expression, and motivation to manage type 2 diabetes were barriers to participation.…”