Determinants of adherence to the online component of a blended intervention for patients with ip and/or knee osteoarthritis: a mixed methods study embedded in the e-exercise trial

Herman de Vries, Corelien Kloek, Dinny de Bakker, Joost Dekker, Daniël Bossen, Cindy Veenhof

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND:
Embedding Web-based interventions within physiotherapy has potential, but knowledge on patient adherence to these interventions is limited.
INTRODUCTION:
This study explores which patient-, intervention-, and environment-related factors are determinants of adherence to the online component of e-Exercise, a 12-week blended intervention for patients with hip and/or knee osteoarthritis.
METHODS:
A convergent mixed methods study was performed, embedded within an ongoing trial. Quantitative data of 109 participants that received e-Exercise were used for negative binomial regression analysis. Adherence was defined as the number of online evaluated weeks. Next, semistructured interviews on factors related to adherence to the online component were analyzed.
RESULTS:
Nineteen participants with missing outcome data because their program was not started were excluded. Of the 90 analyzed participants, 81.1% were evaluated for at least 8 weeks. Adherence was highest for participants with middle education, 1-5-year osteoarthritis duration, and participants who were physiotherapist recruited. The 10 analyzed interviews revealed that sufficient Internet skills, self-discipline, execution of the exercise plan, the intervention's usability, flexibility, persuasive design, added value, and acceptable required time, and research participation were linked to favorable adherence.
DISCUSSION:
It is unknown if patients who adhered to the online component also adhered to their exercise plans. The relationship between adherence to the online component and clinical outcomes will be addressed in a future study.
CONCLUSIONS:
The majority of the participants adhered to the online component of e-Exercise, illustrating its applicability. The integration within the physiotherapy setting and intervention's persuasive design appear to have an important role in optimizing patient adherence.
Translated title of the contributionDeterminanten voor gebruik van de online component van een blended interventie voor patiënten met heup- en/of knieartrose: Een mixed methods studie ingebed in de e-exercise trial
Original languageEnglish
Pages (from-to)1002-1010
JournalTelemedicine and e-Health
Volume23
Issue number12
DOIs
Publication statusPublished - 1 Dec 2017
Externally publishedYes

Keywords

  • osteoarthritis
  • patient adherence
  • physical therapy
  • telemedicine
  • adherence
  • physiotherapy

Cite this

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title = "Determinants of adherence to the online component of a blended intervention for patients with ip and/or knee osteoarthritis: a mixed methods study embedded in the e-exercise trial",
abstract = "BACKGROUND:Embedding Web-based interventions within physiotherapy has potential, but knowledge on patient adherence to these interventions is limited.INTRODUCTION:This study explores which patient-, intervention-, and environment-related factors are determinants of adherence to the online component of e-Exercise, a 12-week blended intervention for patients with hip and/or knee osteoarthritis.METHODS:A convergent mixed methods study was performed, embedded within an ongoing trial. Quantitative data of 109 participants that received e-Exercise were used for negative binomial regression analysis. Adherence was defined as the number of online evaluated weeks. Next, semistructured interviews on factors related to adherence to the online component were analyzed.RESULTS:Nineteen participants with missing outcome data because their program was not started were excluded. Of the 90 analyzed participants, 81.1{\%} were evaluated for at least 8 weeks. Adherence was highest for participants with middle education, 1-5-year osteoarthritis duration, and participants who were physiotherapist recruited. The 10 analyzed interviews revealed that sufficient Internet skills, self-discipline, execution of the exercise plan, the intervention's usability, flexibility, persuasive design, added value, and acceptable required time, and research participation were linked to favorable adherence.DISCUSSION:It is unknown if patients who adhered to the online component also adhered to their exercise plans. The relationship between adherence to the online component and clinical outcomes will be addressed in a future study.CONCLUSIONS:The majority of the participants adhered to the online component of e-Exercise, illustrating its applicability. The integration within the physiotherapy setting and intervention's persuasive design appear to have an important role in optimizing patient adherence.",
keywords = "fysiotherapie, artrose, heupen, kniegewrichten, knie{\"e}n, osteoarthritis, patient adherence, physical therapy, telemedicine, adherence, physiotherapy",
author = "{de Vries}, Herman and Corelien Kloek and {de Bakker}, Dinny and Joost Dekker and Dani{\"e}l Bossen and Cindy Veenhof",
year = "2017",
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language = "English",
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Determinants of adherence to the online component of a blended intervention for patients with ip and/or knee osteoarthritis: a mixed methods study embedded in the e-exercise trial. / de Vries, Herman; Kloek, Corelien; de Bakker, Dinny; Dekker, Joost; Bossen, Daniël; Veenhof, Cindy.

In: Telemedicine and e-Health, Vol. 23, No. 12, 01.12.2017, p. 1002-1010.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Determinants of adherence to the online component of a blended intervention for patients with ip and/or knee osteoarthritis: a mixed methods study embedded in the e-exercise trial

AU - de Vries, Herman

AU - Kloek, Corelien

AU - de Bakker, Dinny

AU - Dekker, Joost

AU - Bossen, Daniël

AU - Veenhof, Cindy

PY - 2017/12/1

Y1 - 2017/12/1

N2 - BACKGROUND:Embedding Web-based interventions within physiotherapy has potential, but knowledge on patient adherence to these interventions is limited.INTRODUCTION:This study explores which patient-, intervention-, and environment-related factors are determinants of adherence to the online component of e-Exercise, a 12-week blended intervention for patients with hip and/or knee osteoarthritis.METHODS:A convergent mixed methods study was performed, embedded within an ongoing trial. Quantitative data of 109 participants that received e-Exercise were used for negative binomial regression analysis. Adherence was defined as the number of online evaluated weeks. Next, semistructured interviews on factors related to adherence to the online component were analyzed.RESULTS:Nineteen participants with missing outcome data because their program was not started were excluded. Of the 90 analyzed participants, 81.1% were evaluated for at least 8 weeks. Adherence was highest for participants with middle education, 1-5-year osteoarthritis duration, and participants who were physiotherapist recruited. The 10 analyzed interviews revealed that sufficient Internet skills, self-discipline, execution of the exercise plan, the intervention's usability, flexibility, persuasive design, added value, and acceptable required time, and research participation were linked to favorable adherence.DISCUSSION:It is unknown if patients who adhered to the online component also adhered to their exercise plans. The relationship between adherence to the online component and clinical outcomes will be addressed in a future study.CONCLUSIONS:The majority of the participants adhered to the online component of e-Exercise, illustrating its applicability. The integration within the physiotherapy setting and intervention's persuasive design appear to have an important role in optimizing patient adherence.

AB - BACKGROUND:Embedding Web-based interventions within physiotherapy has potential, but knowledge on patient adherence to these interventions is limited.INTRODUCTION:This study explores which patient-, intervention-, and environment-related factors are determinants of adherence to the online component of e-Exercise, a 12-week blended intervention for patients with hip and/or knee osteoarthritis.METHODS:A convergent mixed methods study was performed, embedded within an ongoing trial. Quantitative data of 109 participants that received e-Exercise were used for negative binomial regression analysis. Adherence was defined as the number of online evaluated weeks. Next, semistructured interviews on factors related to adherence to the online component were analyzed.RESULTS:Nineteen participants with missing outcome data because their program was not started were excluded. Of the 90 analyzed participants, 81.1% were evaluated for at least 8 weeks. Adherence was highest for participants with middle education, 1-5-year osteoarthritis duration, and participants who were physiotherapist recruited. The 10 analyzed interviews revealed that sufficient Internet skills, self-discipline, execution of the exercise plan, the intervention's usability, flexibility, persuasive design, added value, and acceptable required time, and research participation were linked to favorable adherence.DISCUSSION:It is unknown if patients who adhered to the online component also adhered to their exercise plans. The relationship between adherence to the online component and clinical outcomes will be addressed in a future study.CONCLUSIONS:The majority of the participants adhered to the online component of e-Exercise, illustrating its applicability. The integration within the physiotherapy setting and intervention's persuasive design appear to have an important role in optimizing patient adherence.

KW - fysiotherapie

KW - artrose

KW - heupen

KW - kniegewrichten

KW - knieën

KW - osteoarthritis

KW - patient adherence

KW - physical therapy

KW - telemedicine

KW - adherence

KW - physiotherapy

U2 - 10.1089/tmj.2016.0264

DO - 10.1089/tmj.2016.0264

M3 - Article

VL - 23

SP - 1002

EP - 1010

JO - Telemedicine and e-Health

JF - Telemedicine and e-Health

SN - 1530-5627

IS - 12

ER -