We all know the benefits of a physical therapy home exercise program—and that home exercise compliance can make a huge difference in a patient’s ability to achieve his or her functional goals and remain engaged in a plan of care. But, getting patients (especially those who don’t regularly prioritize physical fitness) to adhere to their prescribed home exercises can be a challenge for even the most motivated physical therapists. After all, you’re essentially trying to convince someone to adopt a new habit, and without a strategy in place to help them commit, you won’t get very far. With that in mind, here are four tips for getting patients to complete their HEPs.
1. Get familiar with the fundamentals of behavioral change.
According to Strive Labs co-founders Ryan Klepps and Scott Hebert, all physical therapists—nay, all healthcare professionals—should be well-versed in the fundamentals of behavioral change theory. According to Hebert, “If terms like social cognitive theory and transtheoretical model only remind you of that one class in PT school you skipped a little too often, then it might be time for a refresher course, because it turns out that people aren’t great at following through with the healthy behaviors we try to help them practice when we create our care plans. And if you don’t know how to help them do so, then there’s a good chance they are going to fail.”
Both Klepps and Hebert contend that surprisingly few people complete their HEPs as prescribed—or exercise regularly. But that’s something physical therapists have the power to change. “By knowing how to use tools like behavioral staging and self-efficacy evaluations to improve your patients’ success, though, you’ll have a much better shot at both achieving desired clinical outcomes and improving patient engagement,” Hebert said.
2. Connect the HEP to the patient’s goal.
One of the best ways to get buy-in from anyone on anything is to connect that thing to the person’s goals. After all, when an individual understands the benefits of something—specifically, how it’ll benefit him or her—that person is more likely to support it. The same holds true whether we’re talking about getting staff buy-in on the implementation of a new piece of technology or getting your patients to buy in to the benefits of completing their HEPs. In the latter scenario, be sure to explain to patients exactly how adhering to their home exercise plans is going to help them meet their functional goals (e.g., picking up a beloved grandchild without low back pain or being able to play in the community soccer tournament next month)—and minimize the number of in-clinic appointments they’ll need to attend and thus, pay for.
You may also want to bring in data to support your claim. For example, if 85% of the patients who are compliant with your home exercises improve significantly faster than the patients who aren’t, that’d be an important bit of information to communicate. And while you’re building up your own data stores in-house, you can refer to any of the numerous studies that have found deleterious effects of HEP non-compliance on clinical outcomes.
3. Celebrate data-backed milestones—both big and small.
You’re already collecting patient-reported outcome measurements, right? Well, as we’ve mentioned previously, you can use that data to guide meaningful conversations with your patients that simultaneously foster engagement and intrinsic motivation. After all, celebrating a milestone—even a small step toward a larger goal—can be a huge motivational boost for a patient. While we don’t recommend bringing out the pom-poms, we do recommend remaining positive, as this will encourage your patients to keep the momentum going—even if they’ve experienced a setback.
While you may have to have an occasional “we’re-not-seeing-the-progress-that-we’d-like” conversation, you’ll want to avoid discouraging your patients or making them feel as though the effort they’ve already given has been for naught. That’s a surefire way to scare patients away from your practice—and maybe even physical therapy in general. Remember: you’re a team. So, even if you have to take a stern approach from time to time, be sure to ask your patients how you can best support them going forward. Then, positively reinforce the next milestone—big or small.
4. Deliver HEPs in an interactive, easy-to-understand format.
As Klepps writes in this article, “When it comes to HEPs, many PTs are still following the same process they’ve been using for the past few decades—a process that clearly doesn’t work:
- Create patient’s exercise program.
- Give patient a print-out of said exercise program.
- At each subsequent visit, ask patient if he or she completed the home exercise program (at which time the patient will likely say something to the effect of, ‘Uh, yeah’).”
If this sounds familiar, then you may be doing a disservice to your patients. Instead, ensure you’re providing your patients with not only the structure and support necessary to complete their prescribed exercises, but also the interactive tools to help them do so safely—and maybe even enthusiastically. And all the while, be sure you’re tracking their progress. That’s where an integrated, mobile-friendly, patient-facing home exercise program like WebPT HEP comes in. With video exercises and a host of other patient-facing features, the WebPT HEP consistently achieves patient engagement rates of more than 50%—10 times higher than the rate denoted in the current Medicare Meaningful Use guidelines. That’s good for your patients—and for your business.
There you have it: four tips for getting patients to do their HEPs. For even more great strategies—including how to “give patients permission to make their HEP work for them,” check out Klepps’s post in full here. In the meantime, though, tell us your own tips for fostering HEP compliance in the comment section below. What successful strategies have you implemented?