Evaluation of causes and predictors of non-attendance at review appointments following treatment of Maxillofacial injuries

Background: Causes and rate of non attendance at review appointment in the outpatient clinics vary widely among various clinics and different  regions all over the world. Solving the problem of non-attendance may therefore require different and individualized approaches tailored to the peculiarity of the clinic and the locality in focus. The aims of this study were to evaluate the causes and the predictors of nonattendance at review appointments following treatment for maxillofacial injuries at a sub Saharan tertiary health facility. Materials and Methods: A prospective, cohort descriptive hospital based study was carried out in a tertiary health facility in South Western Nigeria. Sixty three consecutive adult patients treated for maxillofacial injuries during the study period who met the inclusion criteria were included in the study. The demographic and clinical data of these patients were prospectively collected and analysed. Results: The mean age of the study participants was 34 (range of 17-83) years with a male to female ratio of 5.3:1. Only 17(27.0%) of the patients attended all four clinic review appointments giving an overall default rate of 73.0%. One hundred percent and 30.8% of the patients with mandibular fractures and soft tissue injuries alone respectively attended the first review appointment. The non-attendance rate at the first outpatient review clinic appointment was 28.6% and this progressively increased to 41.3%, 61.9% and 71.4% at the second, third and fourth review clinic appointments respectively. Out of the 18 patients that missed the 1st review appointment, only 1(5.6%) subsequently attended any of the other appointments. Significant factors that are associated with non-attendance at the follow up review clinic appointments following maxillofacial injuries were age of the patients and types of maxillofacial injury. Commonest reasons cited by study participants for default were 'feeling okay', relocation and financial reasons. Conclusion: The most significant factors predicting non-attendance at review appointment following treatment for maxillofacial injuries are type of injuries and age of the patient while the most common reason cited by patient for non attendance was feeling okay. Motivating patients adequately  before discharge by letting them know the advantages of attending and possible implications of not attending post-op review may be a way to improve attendance.