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Patient Adherence

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Human behaviour plays a leading role in whether a patient adheres to an exercise programme or not.(Peek et al. 2015). There are countless drivers of behaviour and reasons why people behave the way they do. These can include personal or individual, social and environmental factors. (Picorelli et al. 2014). According to the transtheoretical model of change, people arrive at different stages of readiness for change. (Hall et al. 2012). Getting patients to behave in a certain way is complex. A physiotherapist must determine what stage they are at to ensure a high level of adherence.
According to “Bandura”, self efficacy is the biggest predictor of adherence. Self efficacy is the belief in one’s ability to succeed in a situation.(Bandura 1977, …show more content…

(Miller et al. 1997). Therefore human communication and behaviour are the main aspects in promoting patient adherence to prescribed exercise programmes. For physiotherapists, the most important thing to ensure a high level of adherence is to individualise to a patient. (McKinney 1989). There is a sufficient amount of evidence showing that the nature and quality of the patient-clinician relationship is a huge determinant of success of recovery. As physiotherapists, we should use the motivational interviewing strategy to understand our patients needs and desires and then to put a tailored plan in place. Physiotherapists need to recognise the importance of using motivational interviewing to drive behaviour change. The use of open and closed questions, reflective listening and positive body language will show real and genuine appreciation of the patient’s struggles and difficulties. Summarising at the end of an appointment is also a fundamental step in establishing high adherence. This will enable a patient to listen to their own story and to show that the physiotherapist has understood what the patient is going through. Encouragement and motivation are essential in promoting adherence. Social support, appropriate advice and empathy along with ease with which a patient can incorporate those recommendations into his …show more content…

and Hamer, P. (2003) 'The physiotherapy experience in private practice: the patients' perspective', Australian Journal of Physiotherapy, 49(3), 195-202.

Resnicow, K., DiIorio, C., Soet, J. E., Borrelli, B., Hecht, J. and Ernst, D. (2002) 'Motivational interviewing in health promotion: it sounds like something is changing', Health Psychology, 21(5), 444.

Thompson, P. D., Buchner, D., Piña, I. L., Balady, G. J., Williams, M. A., Marcus, B. H., Berra, K., Blair, S. N., Costa, F. and Franklin, B. (2003) 'Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity)', Circulation, 107(24), 3109-3116.

Vermeire, E., Hearnshaw, H., Van Royen, P. and Denekens, J. (2001) 'Patient adherence to treatment: three decades of research. A comprehensive review', Journal of clinical pharmacy and therapeutics, 26(5), 331-342.

WCPT (2007) [online], available: http://www.wcpt.org/sites/wcpt.org/files/files/WCPT_Description_of_Physical_Therapy-Sep07-Rev_2.pdf

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