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Patient Compliance

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    Posted: Oct 12 2009 at 9:13am
Our user asked: "I am currently in PT school and we are doing a report on patient compliance and are looking for a professional practicing therapist's views. If this question is not appropriate for this site I apologize and of course if that is the case no response is necesary. Our main questions were: 1- What types of patients (elderly, acutely injured, etc.) seem to systematically seem to have more trouble complying with visits, home exercizes, and general treatment? and 2- What are some simple methods to help overcome these behaviors? Thank you so much for your time."
 
Ask a PT Response: "I work in an outpatient ortho clinic and we don't keep track of what type of patients are noncompliant. We do keep track of why they are not compliant. In the month of September of 2009 we had a non compliance rate of about 18%. The reasons for noncompliance (from greatest to least) includes: personal reasons/out of town, patient/family illness, MD appointment, work conflict, transportation, therapist ill, patient feeling better, patient called after appointment,  injury, in hospital, on hold, funeral, car trouble, patient didn't have new prescription, no show, decreased per physician, MD discharge, weather and scheduling error. 
 
From my personal experience, elderly patients are usually fairly compliant with attending therapy sessions. Worker's compensation patients are fairly compliant as well. It seems that my patients that have the greatest noncompliance issue are patients with T19 insurance. Patient's that are experiencing a high amount of pain also tend to be more noncompliant with performing HEP. Sorry I could not have been of more help.   
 
Some suggestions to facilitate increase compliance are to get to know your patient better. Learn more about your patient and their family, home life, job, hobbies, etc. This will give you a better understanding as to why the patient may be noncompliant. Educate your patient in a manner where they understand what their diagnosis is, what to expect from physical therapy and WHY they are performing the exercises that they are performing. Utilize visual aids such as models, diagrams, books, illustrations, internet if available. Most patients will be more compliant if they understand the diagnosis and what is the purpose of the exercise or treatment. Lastly, having the secretary follow up with the patient by making a phone call to remind the patient of their appointment has been quite effective in our clinic a well. I hope this helps."  
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