OBJECTIVE: To identify measures of adherence to non-pharmacological self-management treatments for chronic musculoskeletal (MSK) populations, and report on the measurement properties of identified measures. DATA SOURCES: Five databases were searched for all study types that included a chronic MSK population, an unsupervised intervention and a measure of adherence. STUDY SELECTION: Two independent researchers reviewed all titles for inclusion using criteria: adult (>18yrs) participants with a chronic MSK condition; the intervention included an unsupervised self-management component; and it contained a measure of adherence to the unsupervised self-management component. DATA EXTRACTION: Descriptive data regarding populations, unsupervised components, measures of unsupervised adherence (items and response options) were collected from each study by one researcher and checked by a second for accuracy. DATA SYNTHESIS: No named or referenced adherence measurement tools were found, but a total of 47 'self-invented measures' were identified. No 'measure' was used in more than a single study. In terms of methods they could be grouped into: home diaries (n=31); multi-item questionnaires (n=11) and single-item questionnaires (n=7). All measures varied in type of information requested and scoring method. The lack of established tools precluded quality assessment of the measurement properties using COSMIN methodology. CONCLUSIONS: Despite the importance of adherence to self-management interventions, measurement appears to be conducted on an ad hoc basis. It is clear that there is no consistency among adherence measurement tools and that the construct is ill-defined. This study alerts the research community to the gap in measuring adherence to self-care in a rigorous and reproducible manner. Thus, we need to address this gap by using credible methods (e.g. the COSMIN guidelines) to develop and evaluate an appropriate measure of adherence for self-management.
AD - The George Institute for Global Health, Oxford Martin School, The University of Oxford, Oxfordshire, United Kingdom; School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland. Electronic address: amandahall@george.org.au.OBJECTIVE: To identify measures of adherence to non-pharmacological self-management treatments for chronic musculoskeletal (MSK) populations, and report on the measurement properties of identified measures. DATA SOURCES: Five databases were searched for all study types that included a chronic MSK population, an unsupervised intervention and a measure of adherence. STUDY SELECTION: Two independent researchers reviewed all titles for inclusion using criteria: adult (>18yrs) participants with a chronic MSK condition; the intervention included an unsupervised self-management component; and it contained a measure of adherence to the unsupervised self-management component. DATA EXTRACTION: Descriptive data regarding populations, unsupervised components, measures of unsupervised adherence (items and response options) were collected from each study by one researcher and checked by a second for accuracy. DATA SYNTHESIS: No named or referenced adherence measurement tools were found, but a total of 47 'self-invented measures' were identified. No 'measure' was used in more than a single study. In terms of methods they could be grouped into: home diaries (n=31); multi-item questionnaires (n=11) and single-item questionnaires (n=7). All measures varied in type of information requested and scoring method. The lack of established tools precluded quality assessment of the measurement properties using COSMIN methodology. CONCLUSIONS: Despite the importance of adherence to self-management interventions, measurement appears to be conducted on an ad hoc basis. It is clear that there is no consistency among adherence measurement tools and that the construct is ill-defined. This study alerts the research community to the gap in measuring adherence to self-care in a rigorous and reproducible manner. Thus, we need to address this gap by using credible methods (e.g. the COSMIN guidelines) to develop and evaluate an appropriate measure of adherence for self-management.
PY - 2014 SN - 1532-821X (Electronic)