Measurement tools for adherence to non-pharmacologic self-management treatment for chronic musculoskeletal conditions: a systematic review

Amanda M Hall; Steven J Kamper; Marian Hernon; Katie Hughes; Gráinne Kelly; Chris Lonsdale; Deirdre A Hurley; Raymond Ostelo

doi:10.1016/j.apmr.2014.07.405

Measurement tools for adherence to non-pharmacologic self-management treatment for chronic musculoskeletal conditions: a systematic review

Arch Phys Med Rehabil. 2015 Mar;96(3):552-62. doi: 10.1016/j.apmr.2014.07.405. Epub 2014 Aug 6.

Authors

Amanda M Hall¹, Steven J Kamper², Marian Hernon³, Katie Hughes⁴, Gráinne Kelly⁵, Chris Lonsdale⁶, Deirdre A Hurley⁷, Raymond Ostelo⁸

Affiliations

¹ School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland. Electronic address: amandahall@george.org.au.
² Musculoskeletal Division, George Institute for Global Health, Sydney, NSW, Australia; EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands.
³ School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland.
⁴ School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland; Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
⁵ Department of Clinical Therapies, University of Limerick, Limerick, Ireland.
⁶ Faculty of Health Sciences, Australian Catholic University, Sydney, NSW, Australia.
⁷ Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
⁸ EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands.

PMID: 25108098
DOI: 10.1016/j.apmr.2014.07.405

Abstract

Objectives: To identify measures of adherence to nonpharmacologic self-management treatments for chronic musculoskeletal (MSK) populations; and to report on the measurement properties of identified measures.

Data sources: Five databases were searched for all study types that included a chronic MSK population, unsupervised intervention, and measure of adherence.

Study selection: Two independent researchers reviewed all titles for inclusion using the following criteria: adult (>18y) participants with a chronic MSK condition; intervention, including an unsupervised self-management component; and measure of adherence to the unsupervised self-management component.

Data extraction: Descriptive data regarding populations, unsupervised components, and measures of unsupervised adherence (items, response options) were collected from each study by 1 researcher and checked by a second for accuracy.

Data synthesis: No named or referenced adherence measurement tools were found, but a total of 47 self-invented measures were identified. No measure was used in more than a single study. Methods could be grouped into the following: home diaries (n=31), multi-item questionnaires (n=11), and single-item questionnaires (n=7). All measures varied in type of information requested and scoring method. The lack of established tools precluded quality assessment of the measurement properties using COnsensus-based Standards for the selection of health Measurement INstruments methodology.

Conclusions: Despite the importance of adherence to self-management interventions, measurement appears to be conducted on an ad hoc basis. It is clear that there is no consistency among adherence measurement tools and that the construct is ill-defined. This study alerts the research community to the gap in measuring adherence to self-care in a rigorous and reproducible manner. Therefore, we need to address this gap by using credible methods (eg, COnsensus-based Standards for the selection of health Measurement INstruments guidelines) to develop and evaluate an appropriate measure of adherence for self-management.

Keywords: Musculoskeletal diseases; Patient compliance; Rehabilitation; Self care.

Publication types

Review
Systematic Review

MeSH terms

Chronic Disease
Humans
Musculoskeletal Diseases / therapy*
Patient Compliance*
Self Care*