title: Interventions for enhancing adherence with physiotherapy: a systematic review.
abstract: Poor adherence to treatment is commonplace and may adversely affect outcomes, efficiency and healthcare cost. The aim of this systematic review was to identify strategies to improve adherence with musculoskeletal outpatient treatment. Five suitable studies were identified which provided moderate evidence that a motivational cognitive-behavioural (CB) programme can improve attendance at exercise-based clinic sessions. There was conflicting evidence that adherence interventions increase short-term adherence with exercise. There was strong evidence that adherence strategies are not effective at improving long-term adherence with home exercise. Due to the multi-dimensional nature of non-adherence, the strategies to improve adherence with physiotherapy treatment are likely to be broad in spectrum. Combined interventions may be effective at promoting adherence with clinic appointments and exercise, though further research would be required to confirm this. Further research to increase basic understanding of the factors, which act as a barrier to adherence, could facilitate development of strategies to overcome non-adherence.
authors.affiliation: Faculty of Health and Well Being, Sheffield Hallam University, Broomhall Road, Sheffield S10 2BP, UK. S.McLean@shu.ac.uk
authors.forename: Sionnadh Mairi
authors.initials: SM
authors.lastname: McLean
authors.forename: Maria
authors.initials: M
authors.lastname: Burton
authors.forename: Lesley
authors.initials: L
authors.lastname: Bradley
authors.forename: Chris
authors.initials: C
authors.lastname: Littlewood
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration; D001294:Attitude to Health; D015438:Health Behavior; D006801:Humans; D009140:Musculoskeletal Diseases / Q000150:complications / Q000534:rehabilitation*; D010146:Pain / Q000150:complications / Q000534:rehabilitation*; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D011369:Professional-Patient Relations; D012047:Rehabilitation Centers / Q000458:organization & administration