Characteristics and reasons for non-attendance at exercise therapy and self-management support among patients with multimorbidity. An exploratory cross-sectional study from the MOBILIZE trial

OBJECTIVE: To describe and compare the characteristics of people living with multimorbidity randomized to personalized exercise therapy and self-management support (the MOBILIZE intervention) stratified by low-medium, and high-attendance.

DESIGN: Cross-sectional study from the MOBILIZE randomized controlled trial, following a pre-specified statistical analysis plan (https://osf.io/tsmjf/).

SETTING: The intervention was delivered by physiotherapists across five municipalities.

PARTICIPANTS: 114 Patients with multimorbidity (≥2 chronic conditions).

INTERVENTION: 24 sessions of exercise therapy and self-management support.

MAIN OUTCOME MEASURES(S): We compared the characteristics of the low-medium (<75% of 24 sessions) and high (≥75%) attendance group using t-test, chi2- or the Mann-Whitney U test, and reasons for non-attendance were identified through participant diary entries.

RESULTS: Among 114 randomized patients (mean age: 70.0 years; 39% female; mean chronic conditions: 7, range 2-19), 76% had high attendance. The low-medium attendance group was younger (-6 years, 95% CI -9.44; -1.67, p=0.006), had lower self-efficacy (SEMCD6 -1.5 points, z=-2.5, p=0.01), and reported more depressive symptoms (PHQ-8 +2 points, z=3.1, p<0.001) and higher treatment burden (MTBQ +7.5, z=2.7, p=0.01). In 61% of missed sessions, the reason for non‑attendance was unknown. Common reasons for non-attendance included illness (18%), vacation (5%), and planned healthcare visits (5%).

CONCLUSION: Patients with a low-medium attendance were younger, had lower self-efficacy, higher depressive symptoms, and higher treatment burden compared to people with a high attendance. Reasons for non-attendance varied widely and should be addressed when prescribing exercise therapy and self-management support for patients with multimorbidity.