Introduction:No prior studies have examined the prevalence of unmet prosthesis need among prosthesis nonusers.

Objectives:The aim of this study was to describe the prevalence of unmet need for an upper-limb prosthesis and identify independent

covariates associated with unmet need for a prosthesis.

Study Design:This study is a telephone survey of 742 persons with upper-limb amputation (ULA).

Methods: Differences between users and nonusers and between nonusers with and without an unmet need were compared statistically.

Covariates associated with unmet need P≤0.2 in bivariate analyses were included in a multivariate logistic regression

model predicting unmet need.

Results: Odds of unmet need were higher for those who stopped using a prosthesis within the past year compared with 20 years

or more ago (odds ratio [OR], 4.30; 95% confidence interval [CI], 1.28–14.51) and those on disability (OR, 4.01; 95% CI,

0.95–16.85). Odds of unmet need were lower for those with higher upper-limb function scores (OR, 0.94; 95% CI, 0.96–1.00),

who were unemployed versus employed/student (OR, 0.15; 95% CI, 0.02–0.98), and those who had abandoned a prior prosthesis

because it was“too much fuss”(OR, 0.41; 95% CI, 0.18–0.92).

Conclusions: Unmet need was prevalent, impacting approximately 50% of persons with upper-limb amputation who were not

using a device and 14% who reported never having used a prosthesis. Independent correlates of greater unmet included worse

upper-limb function, prosthesis use within the prior year, and disability status. Correlates of lesser unmet need included being

unemployed and having abandoned a prosthesis because it was perceived as an undue burden. Further studies are needed to understand

barriers to prosthesis use among nonusers with an unmet need.

Clinical Relevance:Persons with ULA who do not use a prosthesis should be reevaluated regularly to identify unmet needs. Our

findings suggest recent prosthesis users, those with poorer upper-limb function, and those who are employed or on disability are

more likely to have unmet needs. (J Prosthet Orthot. 2023;00:00–00)