Table 5.
Barriers to adherence.
| Investigator reported barriers | Patient reported barriers | |||
|---|---|---|---|---|
| Study author | Data collection method | Assumed barriers | Barriers reported based on study data | |
| Kaskutas, Powell 2013 | Standardised telephone interviews | Not discussed | Not discussed | Difficulties carrying out functional daily activities such as taking care of baby, cooking and job involving keyboard work |
| Kolmus et al 2012 | Participant reported | Not discussed | Not discussed | Patients perceived splint no longer required, therefore removed by 6 weeks |
| Loewenstein et al 2022 | Not clear | Correlation between adherence and financial burden of attending routine appointments. Authors also suggested a link between clinician empathy and adherence | Not discussed | Not discussed |
| Mercurio et al 2023 | Analysis of study data | Not discussed | Correlations between female sex and adherence to the brace, and between adherence to the splint and the number of weeks it was worn, while no correlation emerged between adherence to the brace and functional and psychological results | Not discussed |
| Mottay 2020 | Clinician focus groups | Link between patients’ perception of injury being resolved and early splint removal. Correlation between decreased perception of injury severity and rehabilitation complexity and non-adherence. Language and comprehension of instructions also thought to be a barrier. Suggested link between the financial burden of attending appointments and non-adherence | Not discussed | Not discussed |
| O'Brien 2010 | Patient reported - qualitative interviews | Not discussed | Not discussed | Patients who did not perceive their injury to be significant were less likely to be adherent |
| Also reported that patients believed the outcome will be improved by being adherent to treatment | ||||
| O'Brien and bailey 2011 | Adherence based on a predetermined criterion, using a 3-point scale designed by groth et al | Some assumed barriers inferred related to adherence and attendance to clinical appointments, but not clearly discussed | Not discussed | Not discussed |
| Roh et al 2016 | Barriers identified from correlations between the quantitative data | Correlation between decreased occupational level, physical activity and psychological factors and non-adherence | Correlations between data and adherence, poor health literacy | Not discussed |
| Savaş and Aydoğan, 2022 | Participants completed a questionnaire at 3 weeks | Not discussed | Correlation between non-adherence and Beck's depression inventory score | Difficulties with daily activities e.g using the bathroom, dressing, personal hygiene, grooming, eating, worship, housework, dressing kids, driving, using mobile phone, using remote control, working |
| Also reported not wanting to wear splint and ashamed of splint | ||||
| Some patients reported that they did not care or believe in the splint benefit | ||||
| Silverio, Cheung 2014 | Analysis of study data | Not discussed | Correlation between being a smoker and non-adherence | Not discussed |
| Mortazavi et al 2023 | Patient diaries | Splint discomfort and stiffness | Not discussed | Not discussed |
| Weir et al 2023 | Study data correlated with adherence | Not discussed | Correlation between male sex and higher BMI | Not discussed |
| Cole et al 2023 | Semi-structured interviews and photovoice software | Not discussed | Not discussed | Difficulties carrying out work duties, washing hands, holding mugs, dressing and writing |
| Some patients thought the splint became grubby and did not like the appearance | ||||
| Skin problems also reported due to moisture under splint | ||||