Primary Care in the Spinal Cord Injury Population: Things to Consider in the Ongoing Discussion

Abstract

Purpose of Review Spinal cord injury (SCI) creates unique needs that if not recognized and addressed timely can have detrimental effects on the health and quality of life (QOL) of people living with a SCI. Primary preventive health care is shown to decrease morbidity and mortality, yet the SCI population reportedly faces challenges getting access to this care. This area in SCI health care is still largely understudied with no consensus on the ideal way or which health care provider is best to provide primary care for this population. Findings Preventive care is generally provided by general primary care providers, but not all primary care providers are trained in recognizing and addressing spinal cord injury-specific needs. SCI providers generally are not trained in addressing all aspects of preventive care. Knowing the recommended preventive care screenings, recognizing and managing specific conditions seen after a SCI, and seamless coordination of care between general practitioners and SCI specialists are some of the interventions to help prevent health complications, decrease morbidity and mortality, improve health outcomes, and promote QOL in this patient population. Summary Prioritized focus on preventive care is necessary for a positive impact on the overall health and QOL in this population. Addressing the knowledge gap reported by primary care providers and SCI providers may help increase the probability of SCI patients getting their preventive and specialty care needs addressed. We present a “cheat sheet” of recommendations for the preventive care evaluation of a person living with a SCI.

Unmet healthcare needs, access to services and experiences with health providers among persons with spinal cord injury in Australia

“…A main recommendation must be to improve shared care collaboration to enhance effective communication, interdisciplinary collaboration, and timely access to necessary services and is a responsibility shared between GPs and specialist SCI clinicians. Recent international literature supports this need for greater collaboration between primary, secondary, and tertiary healthcare systems for people with SCI, with the aim of being able to expand on pre-existing healthcare infrastructure [ 40 , 41 ]. Additional recommendations for better care include: adopting a person-centred approach, where people with SCI are actively involved in their care planning and decision-making; offering specialised training and upskilling for GPs on SCI management [ 42 ]; and delivering the right service at the right time, in the right place and by the right provider, thus developing more personalised rehabilitation pathways to allow for tailored interventions and therapies that address the goals of each individual with SCI, leading to improve healthcare access and health outcomes.…”