Correlates of compliance among chiropractic patients treated for low back pain

To test Becker's revision of the Health Belief Model in predicting adherence to a chiropractic regimen, 50 patients diagnosed with recurrent acute lumbago were interviewed regarding health beliefs. All subjects had initiated treatment 12 months before the onset of research. This enabled the calculation of a compliance score for each patient, expressed as the percentage of appointments kept to appointments recommended over a 1-yr period. Posttreatment health beliefs were correlated with the compliance measure. From the four dimensions of the model tested, two categories showed variables having significant associations with appointment keeping. Intention to comply was strongly correlated with compliance (P less than 0.01). However, contrary to the model, subjects' estimates of disability were negatively related with adherence to the program (P less than 0.05). It was suggested that patients reporting high levels of disability showed forced compliance. Clinical applications derived from these results are included to aid chiropractors in the prediction and management of compliance.