International Journal of Physiotherapy and Rehabilitation

Measuring adherence in clinic-based physiotherapy; a study of the inter-rater reliability of a Dutch measurement

*Ellen Ricke
Clinical Epidemiology, Academic Medical Centre, Amsterdam, Netherlands

*Corresponding Author:
Ellen Ricke
Clinical Epidemiology, Academic Medical Centre, Amsterdam, Netherlands
Email:ellenricke@outlook.com

Published on: 2019-06-03

Abstract

Introduction: The assessment of adherence forms an important part of positive treatment outcomes, and there is need to adapting them to the Dutch population.
Objective: To evaluate the inter-rater reliability of the Dutch version of the Rehabilitation Adherence Measure for Athletic Training (RAdMAT-NL) in patients who are undertaking physiotherapeutic rehabilitation in a primary physiotherapy practice.
Design and procedure: Two groups participated in a cross-sectional study conducted between 1 November and 1 December 2017. Two matched physiotherapists independently assessed the adherence of a patient at the end of a treatment using the Dutch version of the 16-item RAdMAT. The inter-rater reliability was evaluated using the intraclass correlation coefficient (ICC) (2,1). The ICC was calculated for all the participants together, after which it was calculated again for patients with musculoskeletal injuries and patients with chronic diseases separately.
Participants: 36 patients—18 with musculoskeletal injuries and 18 with chronic diseases (MS, COPD, dystrophy, Parkinson’s disease and partial paraplegia).
Results: The inter-rater reliability of the RAdMAT-NL is excellent: ICC = 0.98 for all the participants. The inter-rater reliability is also excellent for patients with musculoskeletal injuries (ICC = 0.98) and patients with chronic diseases (ICC = 0.99).
Conclusion: The inter-rater reliability of the RAdMAT-NL is excellent in patients who are undertaking physiotherapeutic rehabilitation in a primary physiotherapy practice.

Keywords

Adherence; Physiotherapy; Measurement; RAdMAT

Introduction

Non-adherence to treatment is a problem across therapeutic areas, also including physiotherapy, with non-adherence rates ranging from 25% to 50%.Poor adherence limits the potential of physiotherapeutic rehabilitation to improve patients’ health and quality of life. Furthermore, this non-adherence has been associated with substantial costs (for patients and society), including avoidable morbidity, increased hospital admissions, and prolonged hospital stays. For example, non-adherent patients with type II diabetes can have annual inpatient costs 41% higher compared to adherent patients. Significant costs can be avoided by increasing adherence. So, non-adherence to physiotherapeutic rehabilitation is a problem of increasing concern to all stakeholders in the health system. At the same time, adherence is the most important factor of treatment that can be influenced to achieve positive treatment outcomes.