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

Introduction

Patient rehabilitation advice (PRA) is commonly used amongst a variety of health care practitioners to aid and enhance the recovery of their patients. Research has demonstrated a positive relationship between the level of adherence to PRA and recovery from a variety of musculoskeletal conditions, and has shown that non-compliance to home-based exercise programs reduces the probability of successful outcome for therapeutic intervention.² No previous research has focused on compliance to prescription and methods of prescription used in the osteopathic medicine setting.

Design

Prospective survey study.

Methods

Over a 5 week period, all consenting return patients of Victoria University Osteopathic Medicine Clinic (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 4th and 5th 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%) non-compliant. When combining prescription types into larger categories, Diagrams were used in 15% of cases to instruct PRA compared to Verbal subgroups of 80%. Verbal had a total compliance of 41 (56%) and non-compliance of 32 (44%), compared to the Diagram total compliance of 11 (61%) and non-compliance of 7 (39%).

Conclusions

As exercise has been shown to augment the treatment efficacy and speed of recovery, it is important that osteopaths are informed of the current adherence rate to PRA and all factors that may cause non-compliance to their exercise prescription. The overall compliance rate to PRA at VUOMC is comparable with previous studies, with the use of diagrams being the least utilised but most effective method of prescription in the VUOMC setting. This study provides a basis for understanding exercise implications that are important both to osteopaths and osteopathic patients, in enhancing treatment results in terms of speed and efficacy, as well as potentially reducing treatment costs to both patients and third party payers.

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