Patient compliance to exercise prescription at the Victoria University Osteopathic Medicine Clinic

Abstract

Research has demonstrated a positive relationship between the level of adherence to PRA and recovery from a variety of musculoskeletal conditions, and has shown noncompliance to home-based exercise programs reduces the probability of successful outcome for therapeutic intervention. No previous research has focused on compliance to prescription and methods of prescription used in the osteopathic medicine setting.Objectives: To establish compliance rates at Victoria University Osteopathic Medicine Clinic (VUOMC) to prescribed home-exercises and to assess current practitioner prescription methods at VUOMC.Design: Prospective survey study. Methods:Over a 5 week period, all consenting return patients of VUOMC were surveyed (N = 94) prior to the commencement of their return treatment visit on their adherence to exercises prescribed at the previous treatment using a tool developed by the researchers. Compliance of patients was calculated by comparing the participants' survey markings of prescription, to those recordings of the prescription made by the treating 4 th and 5 th year student practitioners in the participants' case file.Results: Sixty-seven percent of return patients were prescribed PRA and 33% were not. Total compliance rate to PRA was 55(59%) of respondents, with 39(41%) noncompliant. When combining prescription methods into broader categories, Diagrams were used in 15% of cases to instruct patients in PRA compared to Verbal instruction in 80% of cases. Verbal instruction had a total compliance of 41(56%) and non- Research has demonstrated a positive relationship between the level of adherence to exercise programs and recovery from a variety of musculoskeletal conditions. 2-5 It has also been reported that non-compliance to home-based exercise programs reduces the probability of successful outcome for therapeutic intervention. 3 Despite the positive results shown with adherence to PRA, compliance to practitioner prescribed exercise is low, with a 40-50% dropout rate in the first six months. 4 Therefore, as the need for PRA grows, it is important for practitioners to understand which method of prescription will gain them the greatest amount of patient compliance, and in turn increase speed of patient recovery.Numerous factors affect compliance, the degree to which the advice of a health professional is addressed and followed, 4 with several terms (compliance, motivation, adherence and non-compliance) having overlapping boundaries. Compliance can be described as both an attitude, consisting of the willingness or intent to follow the health prescription, or a behaviour that involves the actual carrying out of the prescription. 1 Non-compliance includes reluctance and behaviour characterised by