title: What Adherence Measures Should Be Used in Trials of Home-Based Rehabilitation Interventions? A Systematic Review of the Validity, Reliability, and Acceptability of Measures.
abstract: To systematically review methods for measuring adherence used in home-based rehabilitation trials and to evaluate their validity, reliability, and acceptability.
  
  
  
  In phase 1 we searched the CENTRAL database, NHS Economic Evaluation Database, and Health Technology Assessment Database (January 2000 to April 2013) to identify adherence measures used in randomized controlled trials of allied health professional home-based rehabilitation interventions. In phase 2 we searched the databases of MEDLINE, Embase, CINAHL, Allied and Complementary Medicine Database, PsycINFO, CENTRAL, ProQuest Nursing and Allied Health, and Web of Science (inception to April 2015) for measurement property assessments for each measure.
  
  
  
  Studies assessing the validity, reliability, or acceptability of adherence measures.
  
  
  
  Two reviewers independently extracted data on participant and measure characteristics, measurement properties evaluated, evaluation methods, and outcome statistics and assessed study quality using the COnsensus-based Standards for the selection of health Measurement INstruments checklist.
  
  
  
  In phase 1 we included 8 adherence measures (56 trials). In phase 2, from the 222 measurement property assessments identified in 109 studies, 22 high-quality measurement property assessments were narratively synthesized. Low-quality studies were used as supporting data. StepWatch Activity Monitor validly and acceptably measured short-term step count adherence. The Problematic Experiences of Therapy Scale validly and reliably assessed adherence to vestibular rehabilitation exercises. Adherence diaries had moderately high validity and acceptability across limited populations. The Borg 6 to 20 scale, Bassett and Prapavessis scale, and Yamax CW series had insufficient validity. Low-quality evidence supported use of the Joint Protection Behaviour Assessment. Polar A1 series heart monitors were considered acceptable by 1 study.
  
  
  
  Current rehabilitation adherence measures are limited. Some possess promising validity and acceptability for certain parameters of adherence, situations, and populations and should be used in these situations. Rigorous evaluation of adherence measures in a broader range of populations is needed.
authors.affiliation: Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, Scotland. Electronic address: rachael.frost@ucl.ac.uk.
authors.forename: Rachael
authors.initials: R
authors.lastname: Frost
authors.affiliation: Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, Scotland.
authors.forename: Sara
authors.initials: S
authors.lastname: Levati
authors.affiliation: Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, Scotland.
authors.forename: Doreen
authors.initials: D
authors.lastname: McClurg
authors.affiliation: Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, Scotland.
authors.forename: Marian
authors.initials: M
authors.lastname: Brady
authors.affiliation: School of Health & Social Care, Edinburgh Napier University, Edinburgh, Scotland.
authors.forename: Brian
authors.initials: B
authors.lastname: Williams
mesh_terms: D003625:Data Collection / Q000379:methods / Q000592:standards; D006801:Humans; D010349:Patient Compliance / Q000706:statistics & numerical data*; D026741:Physical Therapy Modalities / Q000592:standards*; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results
keywords: Patient compliance; Rehabilitation; Reproducibility of results