Interventions to aid patient adherence to physiotherapist prescribed self-management strategies: a systematic review

Kerry Peek; Robert Sanson-Fisher; Lisa Mackenzie; Mariko Carey

doi:10.1016/j.physio.2015.10.003

Interventions to aid patient adherence to physiotherapist prescribed self-management strategies: a systematic review

Physiotherapy. 2016 Jun;102(2):127-35. doi: 10.1016/j.physio.2015.10.003. Epub 2015 Oct 22.

Authors

Kerry Peek¹, Robert Sanson-Fisher², Lisa Mackenzie², Mariko Carey²

Affiliations

¹ Health Behaviour Research Group, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia. Electronic address: Kerry.peek@uon.edu.au.
² Health Behaviour Research Group, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.

PMID: 26821954
DOI: 10.1016/j.physio.2015.10.003

Abstract

Background: Physiotherapist prescribed self-management strategies are an important adjunct to 'hands on' treatment. However, treatment outcomes are likely to be related to whether patients adhere to the prescribed strategy. Therefore, physiotherapists should be aware of adherence aiding interventions designed to maximise patient outcomes underpinned by quality research studies.

Objective: To conduct a systematic review of the interventions used to aid patient adherence to all physiotherapist prescribed self-management strategies.

Data sources: The search included the databases CINAHL, EMBASE, MEDLINE, PUBMED, PSYCINFO, SPORTSDiscus, the Cochrane Central Register of Controlled Trials, PEDro and Mednar for randomised controlled trials (RCTs) published in a peer reviewed journal from inception to November 2014.

Data extraction and synthesis: Data were extracted using a standardised form from twelve included RCTs for patient adherence rates to self-management strategies for interventions used to aid patient adherence and usual care. Two independent reviewers conducted methodological quality assessment.

Results: Twelve different interventions to aid patient adherence to exercise were recorded from twelve fair to high quality RCTs. Potential adherence aiding interventions include an activity monitor and feedback system, written exercise instructions, behavioural exercise programme with booster sessions and goal setting.

Conclusion and implications of key findings: Despite a number of studies demonstrating interventions to positively influence patient adherence to exercise, there is insufficient data to endorse their use in clinical practice. No RCTs examining adherence aiding interventions to self-management strategies other than exercise were identified, indicating a significant gap in the literature.

Systematic review registration number: PROSPERO CRD42015014516.

Keywords: Advice; Exercise; Patient adherence; Physiotherapist; Review; Self-management.

Publication types

Review
Systematic Review

MeSH terms

Exercise Therapy
Formative Feedback
Humans
Patient Care Planning
Patient Compliance*
Patient Education as Topic
Physical Therapy Modalities*
Randomized Controlled Trials as Topic
Self Care*
Social Support