Barriers to Adherence with Post-Operative Hand Therapy Following Surgery for Fracture of the Distal Radius.

Abstract

The success of hand surgery relies heavily on post-operative therapy. The ability to identify barriers to patient adherence with therapy may therefore allow for improvement in therapeutic and surgical decisions and results. The purpose of this study was to identify significant barriers to adherence with hand therapy following surgery for distal radius fracture. A questionnaire addressing demographic, social, psychological, occupational and medical factors was administered to 20 subjects undergoing surgery for distal radius fracture. Adherence was evaluated by the therapist and by the number of missed sessions. There were 9 males and 11 females. Average age was 46.2 (19-88). The therapists' evaluation of adherence and number of missed appointments were significantly correlated (R2 = 0.86, p < 0.0001, Spearman's test). Gender, distance from therapy, and driving status were significantly related to adherence. Difficulty in reaching the therapy sessions was negatively related to adherence with hand therapy in our population. Other parameters such as smoking, were borderline significant. Further study is needed to investigate the effect of additional parameters, in a larger population in order to better define barriers to patient postsurgical adherence.