OnTARi: an ontology for factors influencing therapy adherence to rehabilitation

Abstract

Background Adherence and motivation are key factors for successful treatment of patients with chronic diseases, especially in long-term care processes like rehabilitation. However, only a few patients achieve good treatment adherence. The causes are manifold. Adherence-influencing factors vary depending on indications, therapies, and individuals. Positive and negative effects are rarely confirmed or even contradictory. An ontology seems to be convenient to represent existing knowledge in this domain and to make it available for information retrieval. Methods First, a manual data extraction of current knowledge in the domain of treatment adherence in rehabilitation was conducted. Data was retrieved from various sources, including basic literature, scientific publications, and health behavior models. Second, all adherence and motivation factors identified were formalized according to the ontology development methodology METHONTOLOGY. This comprises the specification, conceptualization, formalization, and implementation of the ontology “Ontology for factors influencing therapy adherence to rehabilitation” (OnTARi) in Protégé. A taxonomy-oriented evaluation was conducted by two domain experts. Results OnTARi includes 281 classes implemented in ontology web language, ten object properties, 22 data properties, 1440 logical axioms, 244 individuals, and 1023 annotations. Six higher-level classes are differentiated: (1) Adherence, (2) AdherenceFactors, (3) AdherenceFactorCategory, (4) Rehabilitation, (5) RehabilitationForm, and (6) RehabilitationType. By means of the class AdherenceFactors 227 adherence factors, thereof 49 hard factors, are represented. Each factor involves a proper description, synonyms, possibly existing acronyms, and a German translation. OnTARi illustrates links between adherence factors through 160 influences-relations. Description logic queries implemented in Protégé allow multiple targeted requests, e.g., for the extraction of adherence factors in a specific rehabilitation area. Conclusions With OnTARi, a generic reference model was built to represent potential adherence and motivation factors and their interrelations in rehabilitation of patients with chronic diseases. In terms of information retrieval, this formalization can serve as a basis for implementation and adaptation of conventional rehabilitative measures, taking into account (patient-specific) adherence factors. OnTARi also enables the development of medical assistance systems to increase motivation and adherence in rehabilitation processes.

Usability of the REHOME Solution for the Telerehabilitation in Neurological Diseases: Preliminary Results on Motor and Cognitive Platforms

“…In this scenario, rehabilitation programs are helpful in mitigating the adverse effects and ensuring improvement in quality of life, especially in progressive and chronic conditions [ 7 , 8 , 9 ]. Some studies have also shown that greater improvements were achieved by ensuring continuity of care in the home environment [ 10 ]. An enhancement of health services could take place using new ICT solutions, where technologies could provide valuable support for both monitoring and rehabilitation purposes in the home and minimally supervised settings [ 13 , 14 ].…”

“…An enhancement of health services could take place using new ICT solutions, where technologies could provide valuable support for both monitoring and rehabilitation purposes in the home and minimally supervised settings [ 13 , 14 ]. Currently however, numerous barriers prevent widespread use of such solutions in elderly and pathological individuals, including aspects of usability, acceptability, motivation, skepticism, and comfort in using digital tools [ 10 , 15 , 16 ].…”

“…This scenario thus imposes significant efforts and challenges for prolonged patient care, and in particular, rehabilitation programs that aim to mitigate the adverse effects and still ensure the best quality of life [ 7 , 8 , 9 ]. Several studies have also shown that rehabilitation outcomes are better when patients can continue rehabilitation treatment at home [ 10 ]. Moreover, it is clear that the health sector will be one of the most affected by the demographic change in the coming years, in terms of the sustainability of health services [ 11 ].…”

“…For example, ICT solutions could support new patient and disease management strategies based on telemedicine and related applications, thereby moving monitoring and rehabilitation services from health care facilities to home settings [ 13 , 14 ], thus favoring continuous and remote follow-up of patients. However, there are still several barriers that limit its deployment in the home environment, including aspects of usability, acceptability, lack of motivation and skepticism in using digital tools, especially in the elderly and individuals with severe chronic disabilities [ 10 , 15 , 16 ].…”

Effectiveness of a rehabilitation protocol after anterior cruciate ligament reconstruction in returning to match rhythm: a case study of a professional soccer player

“…Future research should focus on evaluating various rehabilitation protocols in larger populations to enhance effectiveness (Everard et al, 2021;Hakiki et al, 2021;Gangwani et al, 2022). Understanding predictors of function and activity, as well as the role of adherence factors, can aid in tailoring rehabilitation programs to individual needs (Hakiki et al, 2021;Steiner et al, 2021;Gangwani et al, 2022). Personal factors significantly impact rehabilitation outcomes, emphasizing the importance of individualized interventions (Gangwani et al, 2022;Levac, 2023).…”