Postoperative instructions for human and veterinary patients that have undergone orthopedic surgery typically include a recommendation to return for follow-up examinations to monitor recovery and allow for early recognition and treatment of complications. Studies1,2 of human patients have demonstrated an association between lack of follow-up and poorer clinical outcomes among various patient populations, but to our knowledge, the existence of similar associations for veterinary patients has not yet been investigated. Previous investigators have identified several factors associated with adherence to recommendations for follow-up examinations in human medicine.3–6 For example, a retrospective study6 of human orthopedic patients identified tobacco use, living > 100 miles from a medical clinic, and a lack of private insurance as factors associated with follow-up nonadherence. Clinician communication styles and institutional programs can also influence adherence to recommendations, including recommendations for follow-up examination.7,8
Adherence to recommendations in veterinary medicine has not been thoroughly described. In a study9 of dogs that underwent surgery for apocrine gland anal sac adenocarcinoma, overall adherence to staging recommendations was 21% and adherence to treatment recommendations was 34%. A study8 of general practitioners revealed that 30% of clients adhered to recommendations for dental or surgical treatments for their animals, but adherence was heavily influenced by the way in which the recommendations were communicated by the veterinarian. That study8 specifically investigated adherence to presurgical recommendations, and to the authors’ knowledge, adherence to recommendations for postoperative recheck examinations in companion animals has not been well investigated. However, complete follow-up data seem difficult to obtain for veterinary orthopedic studies,10,11 and anecdotally, we have observed a concerningly low proportion of orthopedic cases treated at our hospital with a known final outcome.
The objectives of the study reported here were to determine owner adherence rates to recommendations for follow-up examination of dogs and cats following orthopedic procedures and identify factors associated with adherence versus nonadherence. We hypothesized that cases involving urgent orthopedic procedures would have poorer follow-up adherence, compared with cases involving elective procedures. We also hypothesized that the distance required to travel to the veterinary hospital, initial procedure cost, animal body weight, species, and number of owners would be associated with follow-up adherence versus nonadherence.
No compensation or funding was received in connection with this study. The authors declare that there were no conflicts of interest.
Keren D, Matter I, Rainis T, et al. Getting the most from the sleeve: the importance of post-operative follow-up. Obes Surg. 2011;21:1887–1893.
Karmisholt J, Andersen S, Laurberg P. Variation in thyroid function in subclinical hypothyroidism: importance of clinical follow-up and therapy. Eur J Endocrinol. 2011;164:317–323.
Strauss K, MacLean C, Troy A, et al. Driving distance as a barrier to glycemic control in diabetes. J Gen Intern Med. 2006;21:378–380.
Gabayan GZ, Asch SM, Hsia RY, et al. Factors associated with short-term bounce-back admissions after emergency department discharge. Ann Emerg Med. 2013;62:136–144.e1.
Peipins LA, Graham S, Young R, et al. Time and distance barriers to mammography facilities in the Atlanta metropolitan area. J Community Health. 2011;36(4):675–683.
Whiting PS, Greenberg SE, Thakore RV, et al. What factors influence follow-up in orthopedic trauma surgery? Arch Orthop Trauma Surg. 2015;135:321–327.
Hendrickson SB, Simske NM, DaSilva KA, Vallier HA. Improvement in outpatient follow-up with a postdischarge phone call intervention. J Am Acad Orthop Surg. 2020;28:e815–e822.
Kanji N, Coe JB, Adams CL, Shaw JR. Effect of veterinarian-client-patient interactions on client adherence to dentistry and surgery recommendations in companion-animal practice. J Am Vet Med Assoc. 2012;240:427–436.
Chambers AR, Skinner OT, Mickelson MA, et al. Adherence to follow-up recommendations for dogs with apocrine gland anal sac adenocarcinoma: A multicentre retrospective study. Vet Comp Oncol. 2020;18(4):683–688.
Watrous GK, Moens NM. Cuttable plate fixation for small breed dogs with radius and ulna fractures: Retrospective study of 31 dogs. Can Vet J. 2017;58(4):377–382.
Forster KE, Wills A, Torrington AM, et al. Complications and owner assessment of canine total hip replacement: a multicenter internet based survey. Vet Surg. 2012;41:545–550.
Lloyd JK. Minimizing stress for patients in the veterinary hospital: why it is important and what can be done about it. Vet Sci. 2017;4(2):1–22.
American Veterinary Medical Association. AVMA Pet Ownership and Demographics Source Book. American Veterinary Medical Association. 2018; 169.
Harkey K, Kaiser N, Inman M, et al. “Are we there yet?”- factors affecting postoperative follow-up after general surgery procedures. Am J Surg. 2018;216(6):1046–1051.
Stone ME Jr, Marsh J, Cucuzzo J, Reddy SH, Teperman S, Kaban JM. Factors associated with trauma clinic follow-up compliance after discharge: experience at an urban Level I trauma center. J Trauma Acute Care Surg. 2014;76:185–190.