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Compliance With Pelvic Floor Physical Therapy in Patients Diagnosed With High-Tone Pelvic Floor Disorders

Woodburn, Katherine L. MD*; Tran, Misha C. BS*; Casas-Puig, Viviana MD; Ninivaggio, Cara S. MD; Ferrando, Cecile A. MD, MPH

Female Pelvic Medicine & Reconstructive Surgery: April 30, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000732
Original Article: PDF Only

Objective The primary objective of this study was to describe patient compliance with pelvic floor physical therapy (PFPT) for high-tone pelvic floor disorders (HTPFD) and to compare patients who are compliant with prescribed therapy to those who are not. The secondary objective is to describe second-line treatments offered for HTPFD for returning patients.

Methods This is a retrospective cohort study of women with a HTPFD who were prescribed PFPT at a tertiary care referral center. Patients were excluded if they had a primary diagnosis of urinary incontinence, had undergone prior PFPT, or if PFPT was part of preoperative planning. Noncompliance with PFPT was defined as not being formally discharged from therapy by the treating therapist.

Results Data on PFPT compliance were available for 662 patients (87.3%). A total of 128 patients (19.4%) were fully compliant. Noncompliant patients were more likely to smoke and to have mental health disease compared with compliant patients (18% vs 8.7%, P = 0.01, and 50.4% vs 37.5%, P = 0.009, respectively). A total of 285 patients (43.1%) returned to their prescribing provider. Noncompliant patients were less likely to return to their provider: 63.4% versus 29.7%, P = <0.0001. Of the patients who returned, 183 (64.2%) were offered second-line treatment.

Conclusions Only 1 in 5 patients referred to PFPT for management of a high-tone pelvic floor disorder is compliant with the recommended therapy. Patients who are noncompliant are less likely to return to their prescribing provider, and less than half of referred patients return. Sixty percent of patients who return are offered second-line treatment.

From the *Obstetrics, Gynecology and Women’s Health Institute; and

Center for Urogynecology and Pelvic Reconstructive Surgery, Obstetrics, Gynecology and Women’s Health Institute, Cleveland Clinic, Cleveland, OH.

Correspondence: Cecile A. Ferrando, MD, MPH, Obstetrics, Gynecology and Women’s Health Institute, Center for Urogynecology and Pelvic Reconstructive Surgery, Cleveland Clinic, 9500 Euclid Ave, A81, Cleveland, OH 44195. E-mail:

C.A.F. receives royalties from UpToDate, Inc. The authors have declared they have no conflicts of interest.

Presented at the Pelvic Floor Disorders Week 2018, American Urogynecologic Society, October 9–13, 2018, Chicago, IL.

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