Caregiver’s adherence to out-patient rehabilitation program of children with cerebral palsy in a tertiary government hospital

Objective: To investigate factors influencing adherence of caregivers to prescribed out-patient management of children with cerebral palsy (CP). Methodology: This prospective cohort study enrolled 106 children with CP and their caregivers seen at the Philippine General Hospital (PGH) from July 1, 2018 to April 30, 2019 to investigate the association of patient profile, caregiver profile, accessibility of treatment center, and type of therapy, to adherence to out-patient management. Results: A total of 106 pediatric patients with CP and their caregivers participated in the study with no dropouts observed. Adherence to therapy was defined as completion of patient of at least 50% of the prescribed therapy sessions or completion of at least one set of therapy. Adherence was significantly increased when patients were referred to: (1) physical therapy (OR=34.5, CI 7.21 to 167, p<0.01); (2) occupational therapy (OR=31.67, CI 3.84, p=0.01); and (3) speech and language therapy (OR=28.12, CI 5.33 to 148, p<0.01). Adherence decreased as the number of types of therapies prescribed increased [(OR=0.83, CI 0.24 to 2.79, p=0.76 for those with 2 therapies); (OR=0.45, CI 0.09 to 2.14, p=0.32 for those with 4 therapies)]. Conclusion: Caregiver’s adherence to out-patient rehabilitation program was seen to be significantly influenced by the type of therapy the patient with CP was referred to undergo (i.e., PT, OT, SLT).