Comparative Effectiveness of Decision Support Strategies for Joint Replacement Surgery

Mass General Brigham

Status: Completed

Conditions: Hip Osteoarthritis; Knee Osteoarthritis

Treatments: Behavioral: Video decision aid; Behavioral: Interactive decision aid; Behavioral: Provider Report

Study type: Interventional

Funder types: Other

Identifiers

NCT02729831

2016P000229

Details and patient eligibility

About

This study is a 2X2 factorial randomized trial that will the examine the comparative effectiveness of two patient decision aids for hip and knee osteoarthritis (OA) as well as the impact of a surgeon-focused intervention.

Full description

This study is a 2X2 factorial randomized trial that will examine the comparative effectiveness of different decision support strategies for patients making treatment decisions about hip or knee osteoarthritis (OA). Eligible patient subjects will be randomly assigned to receive one of two decision aids before their upcoming clinic visit with a participating orthopedic specialist. Participating providers are randomly assigned to either usual care or an intervention (a report that includes patients' goals and treatment preferences). Patient participants will complete three surveys at different time points: before their orthopedic visit, one week after the clinic visit, and 12 months later. Providers will complete a short survey for a subset of patient participants. The study is titled the DECIDE-OA study.

Enrollment: 1,220 patients

Sex: All

Ages: 21+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Diagnosis of either hip or knee osteoarthritis
• Scheduled visit with participating orthopedic surgeon

Exclusion criteria

• prior partial or total knee or hip joint replacement within last 5 years
• hip fracture or asceptic necrosis (AVN) in last 12 months
• Rheumatoid arthritis
• Psoriatic arthritis
• Unable to read English or Spanish
• Unable to consent for self due to cognitive or medical issue
• Hip or knee decision aid provided by Partners Healthcare clinician within 12 months

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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1,220 participants in 4 patient groups

Interactive Decision Aid and Usual Care

Experimental group

Description:

Group receiving brief interactive decision aid and being seen by a provider assigned to usual care. The decision aids are the Shared Decision Points for hip and knee osteoarthritis from Healthwise.

Treatment:

Behavioral: Interactive decision aid

Video decision aid and usual care

Experimental group

Description:

Group receiving long video decision aids and being seen by a provider assigned to usual care. The decision aids are the DVD and Booklets for hip and knee osteoarthritis from Health Dialog.

Treatment:

Behavioral: Video decision aid

Interactive Decision Aid and Provider Report

Experimental group

Description:

Group receiving brief interactive decision aid and being seen by a provider assigned to intervention arm. The decision aids are the Shared Decision Points for hip and knee osteoarthritis from Healthwise. The provider intervention is a report that includes the patients' goals and treatment preferences.

Treatment:

Behavioral: Interactive decision aid

Behavioral: Provider Report

Video decision aid and Provider report

Experimental group

Description:

Group receiving long video decision aids and being seen by a provider assigned to intervention arm. The decision aids are the hip or knee DVD and Booklets for hip and knee osteoarthritis from Health Dialog. The intervention is a report that includes the patients' goals and treatment preferences.

Treatment:

Behavioral: Interactive decision aid

Behavioral: Provider Report