Edinburgh Napier University

  Background and purpose
Little evidence is currently available on adherence to home physiotherapy within paediatrics. This study aims to provide an indication of the likely size of non-adherence with advised home therapy and identify parents' views on non-adherence. It also aims to gain insight on the factors that may influence adherence. Such information is essential for successful treatment regimens and reliable outcome measures.

Method
This pilot study used a modified version of the Manchester cystic fibrosis compliance questionnaire, with a modified health perception component, to survey 58 parents/guardians of children attending for outpatient physiotherapy at two sites.

Findings
Response rates from the two sites were 77.5% and 41.1%. The low response rate from one site may mean that the true level of non-adherence may be higher than found in this study. Only 54.4% of parents declared full adherence to recommended home regimens. 21% of parents were occasionally or often unable to comply. No relationship was found between adherence to the home regimen and background data on attendance or frequency of home treatment. Approximately 50% of children were involved in the instigation and implementation of their home regimen. However, no evidence was found to suggest that the distribution of responsibility influenced adherence. A number of issues leading to non-adherence were identified. Common themes were forgetfulness and lack of time.

Conclusions
This study suggests that there is a clear issue of non-adherence in paediatric physiotherapy. Children are often involved in the provision of the home regimen and the reasons given for non-adherence involved both parents and children. Further in-depth qualitative research is required to explore specific reasons for non-adherence and inform the design of relevant and effective interventions.