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Characteristics and Reasons for Non-attendance at Exercise Therapy and Self-Management Support Among Patients With
Susie M Kaalund1, Søren T Skou2, Sofie R Mortensen3
1Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Central and West Zealand Hospital, Slagelse, Denmark; Research in Recovery and Mental Health Promotion, Amager and Hvidovre Hospital, Centre of Psychiatry Amager, Denmark.
Objective:
To describe and compare the characteristics of people living with multimorbidity randomly assigned to personalized exercise therapy and self-management support (the MOBILIZE intervention) stratified by low-to-medium and high attendance.
Design:
Cross-sectional study from the MOBILIZE randomized controlled trial, following a prespecified statistical analysis plan (https://osf.io/tsmjf/).
Setting:
The intervention was delivered by physiotherapists across 5 municipalities.
Participants:
A total of 114 patients (N=114) with multimorbidity (≥2 chronic conditions).
Interventions:
Twenty-four sessions of exercise therapy and self-management support.
Main Outcome Measures:
We compared the characteristics of the low-to-medium (<75% of 24 sessions) and high (≥75%) attendance groups using t test, chi-square test, or the Mann-Whitney U test, and reasons for non-attendance were identified through participant diary entries.
Results:
Among 114 randomly assigned patients (mean age: 70.0y; 39% women; mean chronic conditions: 7, range 2-19), 76% had high attendance. The low-to-medium attendance group was younger (-6y; 95% CI, -9.44 to -1.67; P=.006), had lower self-efficacy (Self-Efficacy for Managing Chronic Disease 6-Item Scale -1.5 points; z=-2.5; P=.01), and reported more depressive symptoms (Personal Health Questionnaire Depression Scale +2 points; z=3.1; P<.001) and higher treatment burden (Multimorbidity Treatment Questionnaire +7.5; z=2.7; P=.01). In 61% of missed sessions, the reason for non-attendance was unknown. Common reasons for non-attendance included illness (18%), vacation (5%), and planned health care visits (5%).
Conclusions:
Patients with low-to-medium attendance were younger, had lower self-efficacy, higher depressive symptoms, and higher treatment burden compared with those with high attendance. Reasons for non-attendance varied widely and should be addressed when prescribing exercise therapy and self-management support for patients with multimorbidity.
