Low back pain treatment adherence barriers in Eswatini private physiotherapy practices: A pilot study.
Tapiwa Chikaka, Monique M Keller
PMID 39822345WHAT IT FOUND
Most patients attended physiotherapy, but those who did not understand their condition were 6.4 times more likely to miss appointments.
Not having an exercise prescription tripled the odds of defaulting. Simple explanations and clear home programmes appear critical for keeping patients engaged.
Key findings
01Patients who did not understand their condition had 6.4 times higher odds of defaulting scheduled physiotherapy sessions, and those without an exercise prescription had 3 times higher odds.
02The most common reasons for missing appointments were feeling better already (59.7%), pain (33.9%), burden of changing routine (33.9%), and cost (33.9%).
03Pain during exercise was the most cited barrier to performing home exercises (24.1%), followed by fear of doing exercises without supervision (19.4%), lack of time (17.7%), and forgetting exercises (17.7%).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was a small pilot study with high attrition (38 of 100 patients excluded for missing data), so the results cannot prove cause and effect. The survey was self-developed and only assessed for face validity and readability, not robust psychometric properties. The study was limited to private clinics in two regions of Eswatini, which may not represent public healthcare settings or other countries. A significant portion of the sample had tertiary education (95.2%), which may limit generalisability to populations with lower health literacy.
Declared interests
The research received no specific grant from any funding agency.
The easy way to misread this
Do not treat the odds ratios as proof that explaining the condition causes adherence. This is a small pilot study where causality could not be established, and the survey tool was not formally validated.