Associations Between Adherence to Self-Management Activities and Change in Function and Health Outcomes in the Rehabilitation of Patients with Rheumatic and Musculoskeletal Diseases.
Helene Lindtvedt Valaas, Mari Klokkerud, Julie Hildeskår and 10 others
PMID 36633327WHAT IT FOUND
Patients with rheumatic diseases who stuck to their self-management plans improved more in pain, fatigue, physical function, and quality of life over a year.
Adherence did not predict better mental health or daily living skills. Routines were the hardest activities to keep up.
Key findings
01Higher adherence to self-management activities was significantly associated with improvements in pain, fatigue, physical function, goal attainment, quality of life, social participation, and coping.
02Adherence was not significantly associated with improvements in mental health or activities of daily living.
03Patients reported low adherence to activities focused on structure and daily life routines, while high adherence was seen for recreational activities and using health services.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study used a custom, unvalidated method to calculate adherence scores. Participants who dropped out by the 12-month mark were younger, had higher BMI, and were less active, meaning the results may not apply to the most vulnerable patients. The study design is observational, so it shows an association between adherence and improvement, not that adherence caused the improvement. Self-management activities were self-reported, which may introduce bias. Mental health improvements were not maintained after rehabilitation and were not linked to adherence, suggesting the rehabilitation model may have been insufficient for psychological outcomes.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that improving patient adherence to self-management plans will automatically resolve mental health issues or difficulties with activities of daily living, as this study found no significant association between adherence and outcomes in these specific domains.