Análisis de adherencia en modelos híbridos de fisioterapia: estudio observacional

Abstract

Background and objective

The rising number of patients with musculoskeletal disorders and the need to improve continuity of care have led the implementation of hybrid physiotherapy models, which combine in-person sessions with telerehabilitation. Therapeutic adherence and dropout rates are key indicators of the effectiveness of these programmes. The objective of this study was to describe and analyse the level of treatment adherence and compliance, in our patient cohort, to three hybrid physiotherapy care models.

Materials and methods

An observational, analytical, and longitudinal study was conducted, based on retrospective data from the Electronic Health Records of Hospital Universitario Miguel Servet. Data were collected and analysed from adult patients diagnosed with musculoskeletal diseases who received treatment through hybrid models with varying levels of in-person attendance: H1 (low), H2 (moderate), and H3 (high). Sociodemographic variables, adherence (in-person, remote, and total), and clinical dropout were assessed.

Results

The final cohort included 105 patients who began treatment using one of the three hybrid models. Total adherence showed statistically significant differences between the models (p = 0.015), as did adherence to telerehabilitation sessions (p = 0.021). Adherence to in-person sessions was high across all groups, with no significant differences between them. The overall dropout rate was 19%, with significant differences observed between the models (p = 0.014).

Conclusions

An appropriate balance between in-person sessions and telerehabilitation enhances therapeutic adherence and reduces dropout rates. The strategic inclusion of face-to-face sessions strengthens patient engagement and promotes continuity of care.