Skip to main content

Barriers to treatment adherence in physiotherapy outpatient clinics: a systematic review

Jack, Kirsten; McLean, Sionnadh Mairi; Moffett, Jennifer Klaber; Gardiner, Eric


Kirsten Jack

Sionnadh Mairi McLean

Jennifer Klaber Moffett


Poor adherence to treatment can have negative effects on outcomes and healthcare cost. However, little is known about the barriers to treatment adherence within physiotherapy. The aim of this systematic review was to identify barriers to treatment adherence in patients typically managed in musculoskeletal physiotherapy outpatient settings and suggest strategies for reducing their impact. The review included twenty high quality studies investigating barriers to treatment adherence in musculoskeletal populations. There was strong evidence that poor treatment adherence was associated with low levels of physical activity at baseline or in previous weeks, low in-treatment adherence with exercise, low self-efficacy, depression, anxiety, helplessness, poor social support/activity, greater perceived number of barriers to exercise and increased pain levels during exercise. Strategies to overcome these barriers and improve adherence are considered. We found limited evidence for many factors and further high quality research is required to investigate the predictive validity of these potential barriers. Much of the available research has focussed on patient factors and additional research is required to investigate the barriers introduced by health professionals or health organisations, since these factors are also likely to influence patient adherence with treatment.

Journal Article Type Review
Publication Date 2010-06
Journal Manual therapy
Print ISSN 1356-689X
Electronic ISSN 1532-2769
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 15
Issue 3
Pages 220-228
APA6 Citation Jack, K., McLean, S. M., Moffett, J. K., & Gardiner, E. (2010). Barriers to treatment adherence in physiotherapy outpatient clinics: a systematic review. Manual Therapy, 15(3), 220-228.
Keywords Physical Therapy, Sports Therapy and Rehabilitation; General Medicine
Publisher URL
Additional Information Copy of article published in Manual therapy, 2010, v.12, no.3 at http://www.sciencedirec...e/pii/S1356689X09002094


Article (280 Kb)

Copyright Statement
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

You might also like

Downloadable Citations