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

Open access
Jack, Kirsten, McLean, Sionnadh Mairi, Moffett, Jennifer Klaber, Gardiner, Eric·2010·Manual Therapy

Abstract

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.

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Metadata

Authors
Jack, K., McLean, S. M., Moffett, J. K., & Gardiner, E.
Venue
Manual Therapy
Publisher
Elsevier BV
Published
2010-06
Volume
15
Issue
3
Pages
220-228
ISSN
1356-689X (ISSN-L)
OpenAlex
W2018022155
Cited by
924
References
5
FWCI
2.44
Type
journal article
Language
en
Open access
hybrid
Licence

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CoChat. (2026). Citation check: Barriers to treatment adherence in physiotherapy outpatient clinics: A systematic review. https://app.cochat.ai/papers/10.1016/j.math.2009.12.004
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Jack, K., McLean, S. M., Moffett, J. K., & Gardiner, E. (2010). Barriers to treatment adherence in physiotherapy outpatient clinics: A systematic review. Manual Therapy. https://doi.org/10.1016/j.math.2009.12.004

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