It is possible to maintain a high compliance even in the long term: results from the Thermobrace study

Abstract

BackgroundThe importance of compliance monitors is well known;in a previous study, it has been demonstrated that it ispossible to obtain a good real compliance (close to thereferred one), in a setting respecting SOSORT criteriafor bracing. Still, we don t know if, in the long term,compliance remains stable.AimTo verify if it is possible to maintain good brace compli-ance for scoliosis patients, and evaluate what factorscould influence the adherence to the treatment in thelong term.MethodsPopulation. Prospective cohort of 98 Adolescents withspinal deformities (19 males) that have been monitoredwith a heat sensor (Thermobrace) at least twice; 94.9%had AIS. The average monitoring period was: 591.33 +-119.31 days. All patients were treated with brace accord-ing to the SpoRT concept, with a prescription from 8 to23 hours per day; and SEAS exercises; team approachfollowed the SOSORT Bracing Management Guidelines.ResultsReferred compliance remained close to the real, even inthe long period. Most of the patients remained within 2hours from the prescr iption. Median compliance was92.5% (IC 95% 58.8-100.8) for the first download; for thesecond download the median was 92.8% (IC 95% 45.06-102.5%); for the third download the median was 95.5%(IC95% 58.1-105.5) for the fourth download the mediancompliance was 93.70 (IC95% 76.9-108) for all periods itwas 94.6% (Range 9.0-118.9%). At first download 53.6% ofthe patients had at least 90% real compliance; this percen-tage showed a tendency to increase at the second check(60.9%; P=0.11), remaining at 59.6% at the third. In thissample, gender, age, Risser, curve magnitude, and bracetype did not influence compliance. When the weaning per-iod begins, compliance increases; in patients who need tocontinue with a full time prescription, compliance slightlydecreases, even if it remains over 80%.ConclusionIt is possible to maintain a high compliance, even in thelong term; this underlines the importance of the treatingteam, whose aim is to guarantee good end of growthresults. A longer period of monitoring is needed to clearlyrecognize factors influencing compliance.