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Solving the Patient Compliance Challenge

Patient compliance is an on-going challenge for physical therapists. Patients need to attend their physical therapy appointments as prescribed and follow their home exercise programs in order to have optimal outcomes.  A 2010 study in the Journal of Manual Therapy looked at twenty studies to figure out why patients are non-compliant, even though it is in their best interest to attend physical therapy.

Several factors contribute to this issue: low levels of physical activity prior to the start of PT, low in-treatment adherence with exercise, low self-efficacy, depression, anxiety, helplessness, poor social support, greater perceived number of barriers to exercise and increased pain levels during exercise.

Physical therapists can address many of the factors while their patients are in treatment.  Patients complaining of discomfort while exercising often believe that injury is worsening, when in fact; it could be a normal expectation as part of the recovery process.  It is critical that the PT asks the patient about their pain levels during treatment, as well as residual discomfort following treating; maintaining open lines of communication so any issues can be addressed immediately.

While physical therapists can’t control the level of activity prior to PT, they can influence their patients while in treatment and encourage them to start a physical activity program slowly and safely as they heal.   Those who exercise are less likely to experience progressive problems, so it is important for patients to become active.

Setting goals and creating an action plan with the physical therapist can help a patient comply with their treatment plan.  Within that action plan, the PT and patient should discuss any possible barriers; such as childcare, or lack of equipment, and plan accordingly.  It is important that physical therapists review the exercises and make sure that the patient understands and is able to do the exercises as prescribed.

Communication with the patient is key.  Understanding patients’ level of pain, challenges and activity levels and then creating plans to address potential issues can help to improve patient compliance

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