Comparative Effectiveness of Decision Support Strategies for Joint Replacement Surgery: A Factorial Randomized Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Hip Osteoarthritis
- Sponsor
- Massachusetts General Hospital
- Enrollment
- 1220
- Locations
- 3
- Primary Endpoint
- Patients Knowledge
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
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.
Detailed 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.
Investigators
Karen Sepucha
Director, Health Decision Sciences Center
Massachusetts General Hospital
Eligibility Criteria
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
Outcomes
Primary Outcomes
Patients Knowledge
Time Frame: before orthopedic visit
Knowledge sub-score generated from responses to the Hip or Knee Decision Quality Instrument (DQI). Scores range from 0-100%, with higher score meaning higher knowledge.
Percentage of Patients Who Received Preferred Treatment
Time Frame: 1 week after visit with orthopedic surgeon
Patient preferred treatment item from the Hip or Knee Decision Quality Instrument will be compared with the treatment received to determine percentage of patients who received treatment that matched their preferences.
Secondary Outcomes
- Percentage of Participants Who Used the Decision Aid(before orthopedic visit)
- Change in Quality of Life(before orthopedic visit; 12 months from date of orthopedic visit)
- Surgical Rates(6 months after the initial visit)