Swiss Paraplegic Centre, Nottwil, Switzerland; Swiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
Swiss Paraplegic Research, Nottwil, Switzerland.
J Rehabil Med. 2024 Aug 26;56:jrm41083. doi: 10.2340/jrm.v56.41083.
This study aimed to describe the temporal dynamics of and risk factors for non-adherence to outpatient follow-up care in the first 10 years after spinal cord injury.
Retrospective single-centre cohort study using data from medical records and municipal resident registers.
SUBJECTS/PATIENTS: Patients admitted to a specialized spinal cord injury centre in Switzerland discharged between 1 January 2010 and 31 December 2012 (n = 225). Time-to-event analysis was used to investigate the timing of the first non-adherence event, its association with spinal cord injury, and sociodemographic characteristics.
36% of patients were adherent to annual follow-up appointments; 2% formally transferred to another SCI centre; 44% were non-adherent for general reasons (patient's will to discontinue care [12%] or unknown reasons [32%]); and 18% were non-adherent due to death. Risk factors for non-adherence included older age, lack of long-term partner, and more than 2 h of travel time to the clinic. In the youngest age group (18-30 years), 55% were non-adherent after 10 years.
A relevant proportion of individuals with spinal cord injury were lost to annual follow-up care. A holistic approach to patient engagement integrating solutions such as telemedicine and involvement of support networks could reduce the risk of non-adherence.
本研究旨在描述脊髓损伤后 10 年内门诊随访不依从的时间动态和相关风险因素。
回顾性单中心队列研究，使用病历和市居民登记处的数据。
受试者/患者：2010 年 1 月 1 日至 2012 年 12 月 31 日期间在瑞士一家专门的脊髓损伤中心住院的患者（n=225）。采用时间事件分析来研究首次不依从事件的时间、其与脊髓损伤的关联以及社会人口特征。
36%的患者按时接受年度随访预约；2%的患者正式转至另一家脊髓损伤中心；44%的患者因一般原因（患者意愿停止治疗[12%]或不明原因[32%]）不依从；18%的患者因死亡而不依从。不依从的风险因素包括年龄较大、没有长期伴侣以及到诊所的旅行时间超过 2 小时。在最年轻的年龄组（18-30 岁）中，10 年后有 55%的人不依从。
相当一部分脊髓损伤患者未能按时接受年度随访。采用整体方法来增强患者的参与度，整合远程医疗等解决方案，并让支持网络参与其中，可降低不依从的风险。
