Factors Causing Dropout From Treatment During the Ponseti Method of Clubfoot Management: The Caregivers' Perspective
| Autor: | Anisha Agrawal, Alaric Aroojis, Aniruddh Agrawal, Sourabh Sinha, Deepika A Pinto |
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| Rok vydání: | 2021 |
| Předmět: |
Pediatrics
medicine.medical_specialty Clubfoot medicine.medical_treatment education Tenotomy Dropout (communications) behavioral disciplines and activities health services administration mental disorders Medicine Humans Orthopedics and Sports Medicine Child health care economics and organizations Retrospective Studies business.industry Infant medicine.disease Ponseti method Surgery Casts Surgical Treatment Outcome Caregivers business |
| Zdroj: | The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons. 61(4) |
| ISSN: | 1542-2224 |
| Popis: | A retrospective comparative study was conducted, aiming to identify factors associated with dropout from clubfoot treatment by Ponseti method in low- and middle-income countries. A prospectively gathered database of patients who received treatment at a high-volume urban clubfoot clinic over 6 years was queried for dropouts. A "dropout" was identified as any child that had not had a visit within 3 weeks of casting, 4 weeks of tenotomy or 6 months of brace follow-up. The second part of the study was a telephonic interview with caregivers of the identified dropouts to ascertain their reasons for discontinuing treatment. Of the 965 patients treated during the study period, there were 155 (16.06%) dropouts-137 (88.38%) during bracing phase and 18 (11.62%) during casting phase. Age at presentation was significantly higher among the dropouts as compared to those who did not dropout (median 9.5 and 7 months for casting and bracing dropouts respectively versus 3.5 months for regular follow-ups, p.001). No significant correlation was found between patient dropout and sex (p = .061), or laterality (p = .071). Thirty-seven caregivers (23.8%) could be contacted telephonically; including 6 casting and 31 bracing dropouts. The most commonly cited reason for dropout from treatment was lack of family support (75.7%), followed by distance to the clinic (59.5%) and unavailability of transport (54.1%). Sixteen caregivers (43.2%) dropped out on account of migration to another town/state. Maintenance of a meticulous registry with regular update of caregivers' contact details, and interventions to mitigate the identified hurdles can help in reducing treatment dropouts. |
| Databáze: | OpenAIRE |
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