How Do Non-specific Back Pain Patients Think About Their Adherence to Physiotherapy, and What Strategies Do Physiotherapists Use to Facilitate Adherence? A Focus Group Interview Study

Overview

Journal J Man Manip Ther

Specialty Rehabilitation Medicine

Date 2023 Sep 19

PMID 37725067

Authors

A Alt

H Luomajoki

K Roese

K Luedtke

Affiliations

Soon will be listed here.

Abstract

Background: Long-term effectiveness of physiotherapy (PT) for low back pain (LBP) depends on the adherence of patients. Objectives: (1) Identify aspects associated with the adherence of patients with LBP to physiotherapy, and (2) identify factors to facilitate adherence of patients with LBP to PT.

Method: Focus group interviews were conducted with 10 patients with LBP ( = 10, 5 women) and 11 physiotherapists (5 women) from Germany and Switzerland, treating patients with LBP. Data analysis was based on structured content analysis. Deductive and inductive categories were identified and coded.

Results: Patients with LBP requested more and effective home programs, long-term rehabilitation management, and individualized therapy to achieve a higher level of adherence. Physiotherapists requested more time for patient education. Communication, quality of the therapist-patient relationship, and individualized therapy were identified as essential factors by both representatives.

Conclusion: Patients and physiotherapists identified aspects contributing to adherence. These may guide the development of multidimensional measurement tools for adherence. In addition, this information can be used to develop PT approaches to facilitate the level of adherence.

References

Taulaniemi A, Kankaanpaa M, Rinne M, Tokola K, Parkkari J, Suni J . Fear-avoidance beliefs are associated with exercise adherence: secondary analysis of a randomised controlled trial (RCT) among female healthcare workers with recurrent low back pain. BMC Sports Sci Med Rehabil. 2020; 12:28. PMC: 7197113. DOI: 10.1186/s13102-020-00177-w. View

Sakthivel V, Krishnasamy V, Mehalingam V . Level of Medication Adherence and Its Associated Factors among Patients Receiving Antiretroviral Therapy at a Tertiary Care Hospital in South India. J Caring Sci. 2020; 9(2):93-97. PMC: 7322410. DOI: 10.34172/JCS.2020.014. View

Nkhata L, Brink Y, Ernstzen D, Louw Q . A systematic review on self-management education campaigns for back pain. S Afr J Physiother. 2019; 75(1):1314. PMC: 6739526. DOI: 10.4102/sajp.v75i1.1314. View

Cherkin D, Balderson B, Brewer G, Cook A, Estlin K, Evers S . Evaluation of a risk-stratification strategy to improve primary care for low back pain: the MATCH cluster randomized trial protocol. BMC Musculoskelet Disord. 2016; 17(1):361. PMC: 4995645. DOI: 10.1186/s12891-016-1219-0. View

Kolt G, McEvoy J . Adherence to rehabilitation in patients with low back pain. Man Ther. 2003; 8(2):110-6. DOI: 10.1016/s1356-689x(02)00156-x. View

Walti P, Kool J, Luomajoki H . Short-term effect on pain and function of neurophysiological education and sensorimotor retraining compared to usual physiotherapy in patients with chronic or recurrent non-specific low back pain, a pilot randomized controlled trial. BMC Musculoskelet Disord. 2015; 16:83. PMC: 4413527. DOI: 10.1186/s12891-015-0533-2. View

Martin L, Williams S, Haskard K, DiMatteo M . The challenge of patient adherence. Ther Clin Risk Manag. 2008; 1(3):189-99. PMC: 1661624. View

Brincks A, Feaster D, Burns M, Mitrani V . The influence of health locus of control on the patient-provider relationship. Psychol Health Med. 2010; 15(6):720-8. PMC: 4121258. DOI: 10.1080/13548506.2010.498921. View

Alt A, Luomajoki H, Ludtke K . Strategies to facilitate and tools to measure non-specific low back pain patients' adherence to physiotherapy - A two-stage systematic review. J Bodyw Mov Ther. 2023; 35:208-219. DOI: 10.1016/j.jbmt.2023.04.060. View

10.

Carlsen B, Glenton C . What about N? A methodological study of sample-size reporting in focus group studies. BMC Med Res Methodol. 2011; 11:26. PMC: 3061958. DOI: 10.1186/1471-2288-11-26. View

11.

Hugli A, Ernst M, Kool J, Rast F, Rausch-Osthoff A, Mannig A . Adherence to home exercises in non-specific low back pain. A randomised controlled pilot trial. J Bodyw Mov Ther. 2015; 19(1):177-85. DOI: 10.1016/j.jbmt.2014.11.017. View

12.

Zadro J, Shirley D, Simic M, Mousavi S, Ceprnja D, Maka K . Video-Game-Based Exercises for Older People With Chronic Low Back Pain: A Randomized Controlledtable Trial (GAMEBACK). Phys Ther. 2018; 99(1):14-27. DOI: 10.1093/ptj/pzy112. View

13.

Palazzo C, Klinger E, Dorner V, Kadri A, Thierry O, Boumenir Y . Barriers to home-based exercise program adherence with chronic low back pain: Patient expectations regarding new technologies. Ann Phys Rehabil Med. 2016; 59(2):107-13. DOI: 10.1016/j.rehab.2016.01.009. View

14.

Peek K, Carey M, Sanson-Fisher R, Mackenzie L . Physiotherapists' perceptions of patient adherence to prescribed self-management strategies: a cross-sectional survey of Australian physiotherapists. Disabil Rehabil. 2016; 39(19):1932-1938. DOI: 10.1080/09638288.2016.1212281. View

15.

Sengul Y, Kara B, Arda M . The relationship between health locus of control and quality of life in patients with chronic low back pain. Turk Neurosurg. 2010; 20(2):180-5. DOI: 10.5137/1019-5149.JTN.2616-09.1. View

16.

Chakrabarti S . What's in a name? Compliance, adherence and concordance in chronic psychiatric disorders. World J Psychiatry. 2014; 4(2):30-6. PMC: 4087153. DOI: 10.5498/wjp.v4.i2.30. View

17.

Coppack R, Kristensen J, Karageorghis C . Use of a goal setting intervention to increase adherence to low back pain rehabilitation: a randomized controlled trial. Clin Rehabil. 2012; 26(11):1032-42. DOI: 10.1177/0269215512436613. View

18.

Tong A, Sainsbury P, Craig J . Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007; 19(6):349-57. DOI: 10.1093/intqhc/mzm042. View

19.

Lemmers G, Bier J, van Lankveld W, Westert G, Staal J, van der Wees P . Guideline adherence of physiotherapists in the treatment of patients with low back pain: A qualitative study. J Eval Clin Pract. 2022; 28(6):1147-1156. PMC: 9796459. DOI: 10.1111/jep.13703. View

20.

Omeje O, Nebo C . The influence of locus control on adherence to treatment regimen among hypertensive patients. Patient Prefer Adherence. 2011; 5:141-8. PMC: 3090374. DOI: 10.2147/PPA.S15098. View