What adherence measures should be used in trials of home-based rehabilitation interventions? A systematic review of the validity, reliability and acceptability of measures

Rachael Frost, Sara Levati, Doreen McClurg, Marian Brady, Brian Williams

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Abstract

OBJECTIVE: To systematically review methods for measuring adherence used in home-based rehabilitation trials, and evaluate their validity, reliability and acceptability. DATA SOURCES: Phase 1: We searched CENTRAL, EED and HTA (Jan 2000-April 2013) to identify adherence measures used in randomised controlled trials of allied health professional home-based rehabilitation interventions. Phase 2: We searched Medline, Embase, CINAHL, AMED, PsycINFO, CENTRAL, ProQuest and Web of Science (inception-April 2015) for measurement property assessments (MPAs) for each measure. STUDY SELECTION: Studies assessing the validity, reliability or acceptability of adherence measures DATA EXTRACTION: Two reviewers independently extracted data on participant and measure characteristics, measurement properties evaluated, evaluation methods and outcome statistics and assessed study quality using the COSMIN checklist. DATA SYNTHESIS: Phase 1: We included 8 adherence measures (n=56 trials). Phase 2: From 222 MPAs identified in 109 studies, 22 high quality MPAs were narratively synthesised. Low quality studies were used as supporting data. StepWatch Activity Monitor validly and acceptably measured short term step count adherence. The Problematic Experiences of Therapy Scale validly and reliably assessed adherence to vestibular rehabilitation exercises. Adherence diaries had moderately-high validity and acceptability across limited populations. The Borg 6-20 scale, Bassett & Prapavessis' scale and the Yamax CW series had insufficient validity. Low quality evidence supported use of the Joint Protection Behaviour Assessment Polar A1 series heart monitors were considered acceptable by one study. CONCLUSIONS: Current rehabilitation adherence measures are limited. Some possess promising validity and acceptability for certain parameters of adherence, situations and populations and should be used in these situations. Rigorous evaluation of adherence measures in a broader range of populations is needed.
Original languageEnglish
Article numbere45
Pages (from-to)1241-1256
Number of pages16
JournalArchives of Physical Medicine and Rehabilitation
Volume98
Issue number6
Early online date1 Oct 2016
DOIs
Publication statusPublished - Jun 2017

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Reproducibility of Results
Rehabilitation
Population
Exercise Therapy
Allied Health Personnel
Checklist
Randomized Controlled Trials
Joints
Therapeutics

Keywords

  • adherence
  • trials
  • rehabilitation
  • interventions

Cite this

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title = "What adherence measures should be used in trials of home-based rehabilitation interventions? A systematic review of the validity, reliability and acceptability of measures",
abstract = "OBJECTIVE: To systematically review methods for measuring adherence used in home-based rehabilitation trials, and evaluate their validity, reliability and acceptability. DATA SOURCES: Phase 1: We searched CENTRAL, EED and HTA (Jan 2000-April 2013) to identify adherence measures used in randomised controlled trials of allied health professional home-based rehabilitation interventions. Phase 2: We searched Medline, Embase, CINAHL, AMED, PsycINFO, CENTRAL, ProQuest and Web of Science (inception-April 2015) for measurement property assessments (MPAs) for each measure. STUDY SELECTION: Studies assessing the validity, reliability or acceptability of adherence measures DATA EXTRACTION: Two reviewers independently extracted data on participant and measure characteristics, measurement properties evaluated, evaluation methods and outcome statistics and assessed study quality using the COSMIN checklist. DATA SYNTHESIS: Phase 1: We included 8 adherence measures (n=56 trials). Phase 2: From 222 MPAs identified in 109 studies, 22 high quality MPAs were narratively synthesised. Low quality studies were used as supporting data. StepWatch Activity Monitor validly and acceptably measured short term step count adherence. The Problematic Experiences of Therapy Scale validly and reliably assessed adherence to vestibular rehabilitation exercises. Adherence diaries had moderately-high validity and acceptability across limited populations. The Borg 6-20 scale, Bassett & Prapavessis' scale and the Yamax CW series had insufficient validity. Low quality evidence supported use of the Joint Protection Behaviour Assessment Polar A1 series heart monitors were considered acceptable by one study. CONCLUSIONS: Current rehabilitation adherence measures are limited. Some possess promising validity and acceptability for certain parameters of adherence, situations and populations and should be used in these situations. Rigorous evaluation of adherence measures in a broader range of populations is needed.",
keywords = "adherence , trials, rehabilitation, interventions",
author = "Rachael Frost and Sara Levati and Doreen McClurg and Marian Brady and Brian Williams",
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T1 - What adherence measures should be used in trials of home-based rehabilitation interventions? A systematic review of the validity, reliability and acceptability of measures

AU - Frost, Rachael

AU - Levati, Sara

AU - McClurg, Doreen

AU - Brady, Marian

AU - Williams, Brian

N1 - AAM uploaded: 12-12-16; 12m embargo Funding note: Acknowledgement of financial support: Glasgow Caledonian University PhD studentship

PY - 2017/6

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N2 - OBJECTIVE: To systematically review methods for measuring adherence used in home-based rehabilitation trials, and evaluate their validity, reliability and acceptability. DATA SOURCES: Phase 1: We searched CENTRAL, EED and HTA (Jan 2000-April 2013) to identify adherence measures used in randomised controlled trials of allied health professional home-based rehabilitation interventions. Phase 2: We searched Medline, Embase, CINAHL, AMED, PsycINFO, CENTRAL, ProQuest and Web of Science (inception-April 2015) for measurement property assessments (MPAs) for each measure. STUDY SELECTION: Studies assessing the validity, reliability or acceptability of adherence measures DATA EXTRACTION: Two reviewers independently extracted data on participant and measure characteristics, measurement properties evaluated, evaluation methods and outcome statistics and assessed study quality using the COSMIN checklist. DATA SYNTHESIS: Phase 1: We included 8 adherence measures (n=56 trials). Phase 2: From 222 MPAs identified in 109 studies, 22 high quality MPAs were narratively synthesised. Low quality studies were used as supporting data. StepWatch Activity Monitor validly and acceptably measured short term step count adherence. The Problematic Experiences of Therapy Scale validly and reliably assessed adherence to vestibular rehabilitation exercises. Adherence diaries had moderately-high validity and acceptability across limited populations. The Borg 6-20 scale, Bassett & Prapavessis' scale and the Yamax CW series had insufficient validity. Low quality evidence supported use of the Joint Protection Behaviour Assessment Polar A1 series heart monitors were considered acceptable by one study. CONCLUSIONS: Current rehabilitation adherence measures are limited. Some possess promising validity and acceptability for certain parameters of adherence, situations and populations and should be used in these situations. Rigorous evaluation of adherence measures in a broader range of populations is needed.

AB - OBJECTIVE: To systematically review methods for measuring adherence used in home-based rehabilitation trials, and evaluate their validity, reliability and acceptability. DATA SOURCES: Phase 1: We searched CENTRAL, EED and HTA (Jan 2000-April 2013) to identify adherence measures used in randomised controlled trials of allied health professional home-based rehabilitation interventions. Phase 2: We searched Medline, Embase, CINAHL, AMED, PsycINFO, CENTRAL, ProQuest and Web of Science (inception-April 2015) for measurement property assessments (MPAs) for each measure. STUDY SELECTION: Studies assessing the validity, reliability or acceptability of adherence measures DATA EXTRACTION: Two reviewers independently extracted data on participant and measure characteristics, measurement properties evaluated, evaluation methods and outcome statistics and assessed study quality using the COSMIN checklist. DATA SYNTHESIS: Phase 1: We included 8 adherence measures (n=56 trials). Phase 2: From 222 MPAs identified in 109 studies, 22 high quality MPAs were narratively synthesised. Low quality studies were used as supporting data. StepWatch Activity Monitor validly and acceptably measured short term step count adherence. The Problematic Experiences of Therapy Scale validly and reliably assessed adherence to vestibular rehabilitation exercises. Adherence diaries had moderately-high validity and acceptability across limited populations. The Borg 6-20 scale, Bassett & Prapavessis' scale and the Yamax CW series had insufficient validity. Low quality evidence supported use of the Joint Protection Behaviour Assessment Polar A1 series heart monitors were considered acceptable by one study. CONCLUSIONS: Current rehabilitation adherence measures are limited. Some possess promising validity and acceptability for certain parameters of adherence, situations and populations and should be used in these situations. Rigorous evaluation of adherence measures in a broader range of populations is needed.

KW - adherence

KW - trials

KW - rehabilitation

KW - interventions

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DO - 10.1016/j.apmr.2016.08.482

M3 - Article

VL - 98

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EP - 1256

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

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