Compliance with Prescribed Adaptive Equipment: A Literature Review

Abstract

This article describes a literature review that examined the topic of the postdischarge compliance of individuals with prescribed adaptive equipment. Assisting individuals to accomplish tasks relevant to their activities of daily living and thereby achieve functional independence is central to the role of occupational therapy. The prescription of adaptive equipment is a frequently used intervention. The rationale for prescribing adaptive equipment is that it maximises a client's functional potential, allows for independence in activities of daily living and fosters confidence as a result of being able to accomplish such tasks. All studies that surveyed compliance with prescribed adaptive equipment between 1963 and 1996 were reviewed. The factors that reportedly affect compliance by individuals can be considered under five discrete categories: medical-related, client-related, equipment-related, assessment-related and training-related. On the basis of the findings of this literature review, recommendations are made for further research, specifically investigating methods that therapists could incorporate into current practice to address the problem of non-compliance with prescribed adaptive equipment.

Exploring the meaning of a new assistive technology device for older individuals

“…Non-use is deemed problematic because the patient does not receive the full benefit of the intervention [37]. However, the results of this study show that the ATD held meaning for the user even when the ATD was not used.…”

The use of adaptive equipment following total knee replacement

“…The current study found 70% of patients were using, but no longer required, adaptive equipment at week six post-operatively. Unlike the present study, the studies reviewed by Wielandt and Strong (2000) did not complete functional assessments with patients, which may explain the difference in utilisation rate of the studies. By completing a functional assessment at the week six follow up, the researcher was able to demonstrate to the patients that they were independent with the relevant area of function and they no longer required the adaptive equipment.…”

“…However, there is little research which looks at patients' compliance and use of the equipment once it has been issued and patients are discharged home. From the results of their literature review Wielandt and Strong (2000) reported that, following discharge from orthopaedics, use of equipment at six weeks post-operatively was 46%. Reasons for stopping use of the equipment were put down to the patients physical health improving and 'living arrangements', however, the term 'living arrangements' was not explained further.…”

“…It is important then to advise patients to use the equipment for as long as is needed (minimum of 4 weeks) but not for a prolonged period as this may result in reliance on the equipment and reduced independent functional ability. Wielandt and Strong (2000) claim that for orthopaedic conditions, 46% of patients had stopped using the adaptive equipment six weeks after their operation. Wielandt and Strong (2000) do not give details of the specific orthopaedic surgery or conditions within their study.…”

Challenges of user-centred assistive technology provision in Australia: shopping without a prescription

“…The term 'prescription', commonly used to describe an assistive solution recommended to a consumer by a professional, is a symbol of entrenched and legitimised professional power in these approaches [27,28]. Clinical approaches are associated with practitioner expertise, objective measurement, and expectations of patient compliance with prescribed AT devices [29,30]. A key limitation of clinical approaches is that assistive solutions that work in a clinical environment are often difficult to integrate into the environments of their intended use [31].…”