Comparison of Ways to Prepare Patients for Decisions About Joint Replacement Surgery

Ottawa Hospital Research Institute

Status: Completed

Conditions: Osteoarthritis

Treatments: Behavioral: Patient decision aid; Behavioral: Usual care

Study type: Interventional

Funder types: Other

Identifiers

NCT00911638

OHRI-2006724

FIMDM Research Grant 0099-1 (Other Grant/Funding Number)

Details and patient eligibility

About

Ministries of Health consider wait lists for total joint replacement a top priority. Research priorities to manage wait lists indicate the need to establish benchmarks that consider patient preferences. However, patients' preferences for hip or knee replacements are strongly associated with their misperceptions of the indicators for, and the risks and benefits of, these procedures. These misperceptions can be corrected with the use of patient decision aids. When decision aids are used in combination with assessing surgical eligibility, there may be a reduction in unnecessary referrals for surgery either because the patient is ineligible or because the eligible candidates make informed decisions to forgo this option. The primary study objective is to evaluate the effect of patient decision aids (PtDAs) on total wait times (wait times for surgical consultation, plus wait times for surgery) when used in combination with a general practitioner run clinic to screen patients with hip or knee osteoarthritis for surgical eligibility. Major secondary objectives include determining (a) the effect of PtDAs on surgery rates within two years, (b) the effect of PtDAs on decision quality, and (c) cost-effectiveness of PtDAs for total joint arthroplasty.

Full description

This was not indicated as required.

Enrollment: 343 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients referred for surgical consultation for hip or knee osteoarthritis
• WOMAC and HKPT scores indicate that pain and functional criteria are rated as moderate or severe, or there is radiographic evidence of joint damage

Exclusion criteria

• Patients with inflammatory arthritis
• Patients who have had previous TJA
• Patients unable to understand video/DVD decision aids due to deafness, blindness, cognitive impairment, or language barrier

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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343 participants in 2 patient groups

1: Patient decision aid

Experimental group

Description:

Patient decision aid focused on treatment options for osteoarthritis of the hip or knee and preference report for surgeons. The patient decision aid used is from the Informed Medical Decisions Foundation

Treatment:

Behavioral: Usual care

Behavioral: Patient decision aid

2: Usual care

Active Comparator group

Description:

Usual patient educational resources for patients undergoing hip or knee replacement surgery.

Treatment:

Behavioral: Usual care