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Access, cost & insurance··8 min read

Why hand therapy attendance is uneven — and what “adherence” really means

By HandTherapy·Education only; not individualized medical advice.

Public conversations about “drop-off rates” often imply patients are unmotivated. Clinical reality is messier: transportation, work schedules, childcare, pain flares, depression, insurance limits, and clinic distance predict attendance across rehabilitation disciplines.

What systematic reviews tend to find

A broad review of patient adherence notes multifactorial causes and warns against blaming individuals without addressing access and system factors. WHO rehabilitation reports similarly emphasize access, workforce, and continuity of care.

Why hand therapy can be especially attendance-sensitive

  • Appointments may fall during work hours when the injured hand is needed to earn income.
  • Copays accumulate quickly when therapy is prescribed multiple times per week.
  • Pain and swelling can make travel itself a barrier — especially after trauma or surgery.

Tools that support between-visit tracking (symptoms, adherence, summaries) do not replace therapy, but they can reduce “blank memory” at follow-ups — a practical adherence support that respects real life.

Sources & further reading

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