Non-adherence to follow-up care in persons with spinal cord injury within 10 years after initial rehabilitation.
Inge E Eriks-Hoogland, Lorena Müller, Benjamin D N Hirsch and 3 others
PMID 39185548WHAT IT FOUND
Ten years after rehab, only 36% of people with spinal cord injury attended annual follow-ups.
Older age, lack of a partner, and travel times over 2 hours predicted non-adherence. Deaths accounted for 29% of dropouts, while 44% of those who died stopped attending within the first year.
Key findings
01Ten years post-discharge, 36% remained adherent to annual follow-ups, while 62% were non-adherent, with 18% of the total population having died during the follow-up period.
02Age over 61, not having a long-term partner, and car travel times exceeding 2 hours were associated with higher rates of non-adherence among living patients.
03Among those who died during the study, 44% had already missed their first annual follow-up appointment, indicating early disengagement in this subgroup.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was retrospective, so data on reasons for non-adherence relied on telephone interviews that may have been incomplete or biased by recall. Risk factors were assessed only at discharge and not updated over time, so changes in health or social circumstances during the 10-year period were not captured. The centre treats a higher proportion of severe injury cases than average, which may overestimate mortality risks compared to other clinics. Exact death dates were sometimes unknown, potentially affecting the precision of time-to-event analyses for mortality-related non-adherence.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the high non-adherence rate solely as patient disengagement. A significant portion of dropouts were due to death, and nearly half of those who died had already stopped attending appointments within the first year, suggesting that non-adherence may be a marker of declining health rather than just a behavioral issue.