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

Objective: 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. Method: 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). Conclusion: 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.