Patient Follow-up After Orthopaedic Outreach Trips – Do We Know Whether Patients are Improving?

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Patient Follow-up After Orthopaedic Outreach Trips – Do We Know Whether Patients are Improving?


JournalWorld Journal of Surgery
Article typeJournal research article – Clinical research
Publication date – Jun – 2022
Authors – Chelsea Leversedge, Samuel Castro, Luis Miguel Castro Appiani, Robin Kamal, Lauren Shapiro
Keywordslow- and middle-income countries (LMICs), Orthopaedic surgery, traumatic musculoskeletal injuries
Open access – Yes
SpecialityTrauma and orthopaedic surgery
World region Global

Language – English
Submitted to the One Surgery Index on July 6, 2022 at 4:51 am
Abstract:

Background
The burden of traumatic musculoskeletal injuries falls greatest on low- and middle-income countries (LMICs). To help address this burden, organizations host over 6,000 outreach trips annually, 20% of which are orthopaedic. Monitoring post-surgical outcomes is critical to ensuring care quality; however, the implementation of such monitoring is unknown. The purpose of this review is to identify published follow-up practices of short-term orthopaedic surgery outreach trips to LMICs.

Methods
We completed a systematic review of Pubmed, Web of Science, EMBASE, and ProQuest following PRISMA guidelines. Follow-up method, rate, duration, and types of outcomes measured along with barriers to follow-up were collected and reported.

Results
The initial search yielded 1,452 articles, 18 of which were eligible. The mean follow-up time was 5.4 months (range: 15 days-7 years). The mean follow-up rate was 65.8% (range: 22%-100%), the weighted rate was 57.5%. Fifteen studies reported follow-up at or after 3 months while eight studies reported follow-up at or after 9 months. Fifteen studies reported follow-up in person, three reported follow-up via phone call or SMS. Outcome reporting varied among mortality, complications, and patient-reported outcomes. The majority (75%) outlined barriers to follow-up, most commonly noting transportation and costs of follow-up to the patient.

Conclusions
There is minimal and heterogeneous public reporting of patient outcomes and follow-up after outreach trips to LMICs, limiting quality assessment and improvement. Future work should address the design and implementation of tools and guidelines to improve follow-up as well as outcome measurement to ensure provision of high-quality care.

OSI Number – 21664

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