An exploration of adherence to self-management physiotherapy programmes in musculoskeletal physiotherapy using the COM B model and TDF framework

Abstract

Purpose: Musculoskeletal (MSK) disorders are one of the highest causes of disability and financial cost in the UK, and physiotherapists are well placed to manage patients with MSK problems. MSK physiotherapy often includes self-management, requiring patients to undertake some form of behaviour change, including carrying out exercise programmes. Adherence is required in order to benefit from self-management programmes however, adherence rates are suboptimal. Little is known about the provision and content of self-management physiotherapy programmes (SMPP) in NHS MSK outpatient physiotherapy practice, and how these are experienced by patients. It is proposed that the behavioural change wheel, and its underpinning COM-B (capability, opportunity, and motivation-behaviour) model and theoretical domains framework (TDF) can be used in practice to explore patient adherence behaviours.