The Effect of a Telephone Intervention on Adherence to a Home Exercise Program (HEP) in Outpatient Physical Therapy

Purpose/Hypothesis : The home exercise program (HEP) continues to be an essential component of physical therapy practice, yet corresponding patient adherence remains low, especially in patients with chronic versus acute conditions. Research concerning strategies to improve adherence is limited. The purpose of this pilot study was to evaluate the effectiveness of a telephone reminder on adherence to HEPs in older patients with chronic conditions.Number of Subjects : Twenty seven patients, between the ages of 44 and 75, with chronic (lasting > 3 months) medical conditions were successfully recruited from a convenience sample of 9 outpatient physical therapy practices. Eleven (11) subjects were randomly assigned to the experimental group and sixteen (16) to the control group.Materials/Methods : Physical therapists at each facility agreed to give a two-part exercise diary to all patients who agreed to participate in the study. Part I, completed by the therapist, documented the type and number of exercises prescribed for the HEP. Part II, completed by the patient, recorded the number of exercises performed each week by the patient. All patients returned completed diaries each week and received a new diary for the following week. Adherence to the HEP was calculated as the percentage of exercises performed versus the number of exercises prescribed. Patients in the experimental group received a weekly, scripted telephone reminder that reminded them to do the HEP prescribed by their physical therapists. In contrast, patients in the control group did not receive any telephone call reminders. The treating physical therapists did not know which patients were assigned to the experimental or control groups.Results : The patients in the experimental group remained in the study longer than those in the control group. At five weeks into the study, 64% of patients receiving the telephone reminders were still adhering to the study protocol, in contrast to 50% of those patients who did not. There was no significant difference between participants in the experimental group who reported completing an average 89.97% (SD =11.20%) of exercises prescribed and control participants who completed on average 86.95% (SD =24.60%). The smaller standard deviation for the experimental group suggests that the participants who received telephone reminders performed their exercises more consistently.Conclusions : Indirect effects in patients given telephone reminders were evident with more consistent exercise (decreased variance) and study participation when compared to those who did not received any reminders. Telephone reminders, however, did not significantly increase overall adherence to HEPs in this pilot sample of older patients with chronic conditions.Clinical Relevance : In this study, telephone reminders had an indirect clinical benefit towards adherence to HEPs in older patients with chronic conditions. Future study of the effects of reminders on adherence with larger samples of patients in various age groups is recommended, and would allow more comprehensive analysis.

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  • Control #: 1723343
  • Type: Poster
  • Event/Year: CSM2014
  • Authors: Maryanne Driscoll, Vanessa Reddin, Matthew Holtzer, Justin Majeed, Nikolay Soni, Adeel Rizvi, Wesley Varghese
  • Keywords: Patient Adherence|Home Exercise Program

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