Researchers of this study found providing patients with a decision aid improved their decision making about whether to undergo total knee arthroplasty. The study also showed no significant difference in surgical wait times between these patients and a cohort who received a hospital pamphlet for decision making.
“Recruitment of patients with osteoarthritis considering surgery and data collection were feasible,” the authors wrote in their study abstract. “As some patients remained on the surgical waiting list after 1 year, follow-up should be extended to 2 years. Patients exposed to the patient decision aid achieved higher decision quality compared to those receiving usual education, but there was no difference in wait for surgery.”
The researchers conducted a prospective, two-arm randomized controlled trial of 142 patients who received a patient decision aid (PtDA) and 77 patients in the usual education group who received an information booklet from the hospital. The PtDA provided details on different knee osteoarthritis treatment options so patients could make an informed decision on whether to undergo surgery. The average age of patients was 67 years and most were women.
The researchers found 93% of patients completed the PtDA questionnaire. At 1-year follow-up in the PtDA group, there were eight patients on the surgical waiting list; one patient died; 55 patients underwent surgery and five opted for nonsurgical management. In the usual education group, 48 patients underwent surgery; nine patients had nonsurgical management; 10 patients were on the waiting list and one patient died at 1-year follow-up.
There was no difference in surgical wait times from the time of consultation to the time of decision making between groups. The PtDA group waited an average of 33.4 weeks and the usual education group an average of 33 weeks.
“A subsequent trial should follow patients for longer than 1 year and repeat decisional conflict measures before and after surgical consultation,” the authors wrote in the study. “Findings were used to inform the design and redefine primary outcomes of a larger scale study.” — by Renee Blisard Buddle
Disclosure: Stacey, Hawker, Tugwell, Boland, Pomey, O’Connor and Taljaard have no relevant financial disclosures. Dervin is a paid consultant for Stryker Corporation. The study was funded by the University of Ottawa, Canada.
