Abstract
Objectives
To identify measures of adherence to nonpharmacologic self-management treatments for
chronic musculoskeletal (MSK) populations; and to report on the measurement properties
of identified measures.
Data Sources
Five databases were searched for all study types that included a chronic MSK population,
unsupervised intervention, and measure of adherence.
Study Selection
Two independent researchers reviewed all titles for inclusion using the following
criteria: adult (>18y) participants with a chronic MSK condition; intervention, including
an unsupervised self-management component; and measure of adherence to the unsupervised
self-management component.
Data Extraction
Descriptive data regarding populations, unsupervised components, and measures of unsupervised
adherence (items, response options) were collected from each study by 1 researcher
and checked by a second for accuracy.
Data Synthesis
No named or referenced adherence measurement tools were found, but a total of 47 self-invented
measures were identified. No measure was used in more than a single study. Methods
could be grouped into the following: home diaries (n=31), multi-item questionnaires
(n=11), and single-item questionnaires (n=7). All measures varied in type of information
requested and scoring method. The lack of established tools precluded quality assessment
of the measurement properties using COnsensus-based Standards for the selection of
health Measurement INstruments methodology.
Conclusions
Despite the importance of adherence to self-management interventions, measurement
appears to be conducted on an ad hoc basis. It is clear that there is no consistency
among adherence measurement tools and that the construct is ill-defined. This study
alerts the research community to the gap in measuring adherence to self-care in a
rigorous and reproducible manner. Therefore, we need to address this gap by using
credible methods (eg, COnsensus-based Standards for the selection of health Measurement
INstruments guidelines) to develop and evaluate an appropriate measure of adherence
for self-management.
Keywords
List of abbreviations:
COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments), HCP (health care professional), MSK (musculoskeletal), WHO (World Health Organization)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 06, 2014
Footnotes
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
