Bamford Emma, Mawhinney Jamie A, Johnson Nick, Shelton Ian, Selby Anna, Drummond Avril
Pulvertaft Hand Centre, Derby, UK.
University of Nottingham, Nottingham, UK.
Hand Ther. 2024 Dec;29(4):161-174. doi: 10.1177/17589983241268069. Epub 2024 Aug 12.
Non-adherence to splint wearing following an upper limb traumatic injury is a significant medical issue. Optimal outcome following such injuries relies on people adhering to the prescribed splint, and a failure to do so can negatively impact outcome and increase healthcare burden and costs. This systematic review aims to compare and synthesise the evidence related to measuring adherence to wear recommendations and the barriers to splint wearing following upper limb trauma in adults.
Databases (EBSCO, PubMed, EMBASE and Science Direct) were systematically searched for articles that met the pre-agreed eligibility criteria between February and May 2023. Data on study characteristics and reported outcomes relating to measuring and quantifying splint adherence and barriers to adherence were extracted.
A total of 16 articles were included for final review. Several methods were used to measure adherence, with no single tool used predominantly. These included patient or therapist reported data, preexisting classification systems and an electronic device. Methods used to quantify adherence was also heterogenous in nature, and a range of investigator and patient reported barriers to splint wearing were reported.
This review demonstrates heterogeneity in both classifying and measuring splint adherence, as well as in the barriers to splint wearing reported. Moving forward, using agreed measurement and reporting practices for splint adherence will enable researchers to complete high quality trials to determine splinting outcomes, and may ultimately enable health care professionals to improve adherence and, subsequently, outcomes in clinical practice.
上肢创伤后不遵守夹板佩戴规定是一个重大的医学问题。此类损伤后的最佳治疗效果依赖于患者遵守规定佩戴夹板，而未能做到这一点会对治疗效果产生负面影响，并增加医疗负担和成本。本系统评价旨在比较和综合与测量遵守佩戴建议情况以及成人上肢创伤后夹板佩戴障碍相关的证据。
在2023年2月至5月期间，系统检索数据库（EBSCO、PubMed、EMBASE和ScienceDirect），以查找符合预先商定的纳入标准的文章。提取有关研究特征以及与测量和量化夹板依从性及依从性障碍相关的报告结果的数据。
共纳入16篇文章进行最终评审。使用了多种方法来测量依从性，没有一种工具被广泛使用。这些方法包括患者或治疗师报告的数据、现有的分类系统和电子设备。用于量化依从性的方法在本质上也各不相同，并且报告了一系列研究人员和患者提到的夹板佩戴障碍。
本综述表明，在夹板依从性的分类和测量以及所报告的夹板佩戴障碍方面均存在异质性。展望未来，采用商定的夹板依从性测量和报告方法将使研究人员能够开展高质量试验以确定夹板治疗效果，并最终可能使医疗保健专业人员提高依从性，进而改善临床实践中的治疗效果。
