Adherence to Behavioral Interventions for Urge Incontinence When Combined With Drug Therapy: Adherence Rates, Barriers, and Predictors

Abstract

Most women adhered to exercise during supervised intervention; however, adherence declined over the long term. Interventions to help women remember to exercise and to integrate PFM exercises and UI prevention strategies into daily life may be useful to promote long-term adherence.

Predictors of adherence to home-based physical therapies: a systematic review

“…Although the HBPTs studied did vary, several therapies were the subject of multiple studies. Specifically, rehabilitation exercises following ACL-repair surgery was the subject of five studies [24,34,35,39,40]; Pelvic Floor Muscle Exercise (PFME) therapy for symptoms of urinary incontinence was investigated in four studies [15,[36][37][38]; rehabilitation exercises following sports injury was investigated in three studies [32,33,41]; physiotherapy exercises as part of falls prevention interventions were also the subject of three studies [42][43][44]; dizziness and balance disorders were investigated by two studies [19,45], as were upper limb disorders and injuries [46,47], non-specific neck or low back pain [20,48], and osteoarthritis of the hip or knee [49,50]. Other HBPTs investigated were for stroke rehabilitation [51]; osteoporosis [18]; rheumatoid arthritis [52], and ankle sprains [53].…”

“…Five studies' samples were gender specific to females [15,18,[36][37][38], but all others were F o r P e e r R e v i e w 8 Running head: Adherence to home-based physical therapies mixed. The mean age of samples was also often determined by the condition investigated.…”

“…However, only the overall regression model was reported which does not provide information about the size of the association with perceived severity [41]. Amongst studies investigating predictors of adherence to home-based PFME therapy, potentially more objective symptom severity, in terms of frequency and severity of urine loss, were shown to be associated with adherence in three studies [15,36,38] but not in another [37]. However, it is not clear whether this more objective consideration of severity in terms of counting occurrences of symptoms is predictive of adherence amongst other patient populations.…”

“…Study-specific factors, for example, level of fluid intake in relation to PFME adherence [15], will not be discussed as little can be strongly concluded or generalised from these to HBPT more generally.…”

“…[7]. Self-managed HBPTs in particular, often demonstrate the lowest levels of patient adherence amongst physical therapy modalities [14,15]. Nonetheless, for adherent patients, HBPT can be superior to standard care [16].…”