Common Barrier to Patient Adherence/Engagement with Physical Therapy

Question

Answer

The major barrier is depression.  There is a free app available for Droid and iPhone called the Geriatric Depression Scale.  There is a 15-item scale and a 5-itme scale that has been validated to the 15.  It is 15 yes/no questions.  The scoring is with a 0 or a 1 and then you add the scores.  If they get a certain number or greater, then it is predictive of depression and you would want to refer to a physician, social worker, or behavioral health.  For my patients who are not doing the program that I am asking them to do and they are not eating or drinking well, or they appear to have depression or have no motivation, I will do the GDS 15.  Based on those results, I will refer them to the nurse, physician or social worker.  Sometimes I may even stop therapy at that point until they get properly medicated.  They may need an antidepressant, and then I would come back in a couple of weeks once they have the motivation.  Then we can make effective change.  If I go in there and they are not exercising or doing the program, then I would rather wait and make the visits when they will be more effective.  I would recommend that you start doing the GDS 15.  It takes less than 5 minutes.