AA

Key Points

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  • A large majority of people with spinal cord injuries (SCI) have a family doctor and are satisfied with care received.
  • People with spinal cord injuries tend to be high users of primary care.  Many people with SCI receive their primary care from a physiatrist or other specialist.
  • Lack of SCI-specific knowledge is a significant problem for people with SCI in primary care.  There is evidence for inadequate knowledge of important secondary conditions and lack of adherence to clinical guidelines in treating SCI patients.
  • Physical barriers are also encountered in some primary care practices.
  • The majority of the issues raised by SCI patients in primary care are disability-related – specifically, they are secondary complications of the spinal cord injury.
  • There is a high level of consistency in the literature on the most common issues raised by people with spinal cord injuries in primary care.
  • The most commonly raised issues are bowel, bladder and pain.  Also of significant concern are skin care, equipment and medication needs, depression and bone density.
  • Unmet health needs are a significant problem for people with SCI in primary care, with information needs in particular being poorly met.
  • There is evidence for the effectiveness of outreach programs for maintaining health among patients with SCI.  In particular, web-based and telephone-based technologies show promise in this area.