Rates and reasons for non-adherence to home physiotherapy in paediatrics: Pilot study

Background and Purpose. Little evidence is currently available on adherence to home physiotherapy within paediatrics. This study aims to provide an indication of the likely size of non-adherence with advised home therapy and identify parents' views on non-adherence. It also aims to gain insight on the factors that may influence adherence. Such information is essential for successful treatment regimens and reliable outcome measures. Method. This pilot study used a modified version of the Manchester cystic fibrosis compliance questionnaire, with a modified health perception component, to survey 58 parents/guardians of children attending for outpatient physiotherapy at two sites. Findings. Response rates from the two sites were 77.5% and 41.1%. The low response rate from one site may mean that the true level of non-adherence may be higher than found in this study. Only 54.4% of parents declared full adherence to recommended home regimens. 21% of parents were occasionally or often unable to comply. No relationship was found between adherence to the home regimen and background data on attendance or frequency of home treatment. Approximately 50% of children were involved in the instigation and implementation of their home regimen. However, no evidence was found to suggest that the distribution of responsibility influenced adherence. A number of issues leading to non-adherence were identified. Common themes were forgetfulness and lack of time. Conclusions. This study suggests that there is a clear issue of non-adherence in paediatric physiotherapy. Children are often involved in the provision of the home regimen and the reasons given for non-adherence involved both parents and children. Further in-depth qualitative research is required to explore specific reasons for non-adherence and inform the design of relevant and effective interventions.