Factors associated with non-attendance at early review appointments after cleft lip and palate repair at a Nigerian specialist maxillofacial centre

Abstract

Background

The best outcome of orofacial cleft (OFC) management is predicated on appropriate surgical intervention and patients’ regular attendance of scheduled review appointments. Non-attendance at scheduled attendance by patients can adversely affect the eventual outcome of management. The study aimed to determine the factors responsible for missed scheduled review appoint­ment following cleft repair surgery.

Methods

This is a prospective cohort study of consenting parents of all children that had cleft repair surgery between February 2012 and March 2013. A semi-structured questionnaire with information including socio-demographic characteristics and reason for failure to attend five scheduled review appointments was used.

Results

Sixty-two parents with completed information were included in the analysis. There was a progressive drop in the number of patients attending review appointments over time and this was statistically significant (p=0.0001). The reasons for missed ap­pointment varied, including medical illness of patient or parent and financial constraints. The statistical significant predictors of attendance at the early review follow-up clinic were living within Abeokuta (OR 4.431, 95%CI 1.224-16.041, p=0.023) and earning higher income (OR 5.118, 95%CI 1.423-18.410, p=0.012).

Conclusions

Missed appointment was common over time. Illness, pressure of work and financial constraints were mainly responsible for non-attendance. There is need for cleft care plan that takes care of both caregiver and patient and also for it to be more accessible.