COMPLIANCE AND BARRIERS TO PHYSIOTHERAPY AMONG PERSONS WITH PARKINSON’S DISEASE AT THE KORLE BU TEACHING HOSPITAL: EXPLANATORY MIXED-METHOD STUDY

M.W. Agoriwo¹, P.G. Adorvlo¹, P. Oppong Junior¹, B. Atsivor², E. Mensa-Bonsu¹

¹University of Health and Allied Sciences, Department of Physiotherapy and Rehabilitation Sciences, Ho, Ghana, ²Korle Bu Teaching Hospital, Physiotherapy Department, Accra, Ghana

Background: In Ghana, Parkinson’s disease (PD) is recorded among the three most common non-communicable diseases increasing the burden of neurological disorders in Ghana. Though, PD currently has no cure, there is moderate to strong evidence for regular physiotherapy or exercises in improving physical and cognitive function among persons with PD. For continuous effective rehabilitation of persons with PD, adherence, and compliance is necessary for achieving targeted functional goals.

Purpose: To assess the compliance rate and barriers to adherence for physiotherapy among persons with PD reporting at the physiotherapy PD clinic of the Korle Bu Teaching Hospital from 2013 to 2021.

Methods: An explanatory sequential mixed-method study design was used (quantitative retrospective survey of patients’ health records followed by phone interviews among defaulters). Researcher designed data collection tool was used to extract relevant information such as patient demographic details, telephone numbers, dates of first and last attendance, and current state of physiotherapy attendance from the records of patients with PD who received treatment at the physiotherapy PD clinic from May 2013 to December 2021. Subsequently, patients in the year with the highest attendance, who had defaulted were invited to participate in an interview via phone call. A structured phone interview was conducted with consented participants using an interview guide. The interview was recorded with patient’s permission and lasted for 20minutes. The data collection tool and the interview guide were piloted for validity and reliability. Descriptive statistical analysis was applied to the quantitative data while the interviews were transcribed verbatim for thematic content analysis.

Results: A total of 86 PD cases were obtained within the years under review (2013-2021) with 56(65.1%) males. The overall mean age was 66.97(±11.29) with a range of 38-90 years and a male to female ratio of 2:1. Patients recorded mild to severe PD with a mean disease stage of 2.5(±0.851) and duration of 3.63(±3.77) years. The year 2014 recorded the highest number of cases (n=20/86;23.3%) with 2021 recording the least (n=3/86;3.5%). Overall, only 5(5.8%) patients were still attending physiotherapy, 88.4% had defaulted, and 5.8% had died. The overall compliance rate per the average expected (13.44) and actual (8.16) number of visits was recorded as 60.7%. Out of the 20 patients recorded for 2014, 6 (3 males) consented to participate in the interviews, 2 declined and 12 could not be reached. Mean age of interview participants was 64.8(±8.08) years and age range of 52-74 years. System level barriers were recorded as the main reasons for patients defaulting physiotherapy. These included inaccessibility and cost of transportation, cost involved in treatment and waiting time, dissatisfaction with therapy and unavailability of equipment. At the individual level barriers, only one patient indicated poor family support as a reason for stopping physiotherapy.

Conclusions: Majority of persons with PD are not adhering to physiotherapy and system level barriers are the main reasons.

Implications: Knowledge of these barriers will provide basis for PD-Specific training for physiotherapists and the need for many rehabilitation or physiotherapy units to be established in Ghana.

Funding acknowledgements: There was no funding for this study

Keywords:
Parkinson's disease
Physiotherapy
Compliance

Topics:
Neurology: Parkinson's disease
Neurology
Disability & rehabilitation

Did this work require ethics approval? Yes

Institution: University of Health and Allied Sciences (UHAS)

Committee: UHAS Research Ethics Committee

Ethics number: UHAS-REC A.10 [5] 21-22