Background/Purpose: Video modelling is often used in patient education to improve patient outcomes. We conducted a multi-centered, open-label, parallel, randomized controlled trial that evaluated the efficacy of a multimedia patient education tool (MM-PtET) in patients with knee osteoarthritis (kOA).

Methods: Patients were recruited from 5 centers and through advertisement. Inclusion criteria were: (i) age ≥50, (ii) prior diagnosis of knee OA (unilateral or bilateral) by a physician, (iii) adequate cognitive status, and (iv) ability to communicate in English or Spanish language. Participants completed a baseline questionnaire and then were randomized through an institutional web system to receive either a MM-PtET (including storylines and testimonials) in combination with a written booklet or a written booklet alone (with the same content). Follow-up included a post-intervention, 3 and 6-month questionnaires. Primary outcome measures were: disease knowledge, decisional conflict, and role preferences. Secondary outcomes included: self-efficacy and disease management.

Results: 219 participants were randomized (n=109, MM-PtET + written booklet; n=110 written booklet alone). Mean age was 65±8 years, 76% were female, 82% had adequate health literacy, and 11% spoke Spanish. 173 (83=MM-PtET, 90=booklet) and 189 (98=MM-PtET, 91=booklet) participants returned their questionnaires at 3 and 6 months, respectively.  Within groups most outcomes were improved from baseline to 3 and 6 months.  At 3 months, participants receiving the MM-PtET + written booklet had lower scores on the uninformed scale of the decision conflict measure compared to those receiving the booklet alone (25.4 vs 32.7, p=0.05).  Linear regression showed that Spanish-speakers patients who received the booklet had higher decisional conflict at 6 months compared to baseline (mean difference=18; p=0.04), while those who received MM-PtET had lower conflict (mean difference=-23, p=0.02) and felt less uninformed (p=0.04). Also, having a Bachelor’s degree or higher was associated with improved clarity scores after 6 months (p=0.01). Greater improvement in self-efficacy was observed among English speaking patients, receiving the control, and among females, receiving the intervention (p=0.02 and p<0.05, respectively). Generalized estimating equation analysis showed that after adjusting for correlated outcome data and controlling for other variables, Caucasian (as compared to Hispanic), and higher educated participants (p=0.009 and p=0.01) were more likely to prefer playing an active role on disease management.  Also, among patients with inadequate health literacy, those who received the intervention had higher odds of choosing active role than controls (OR=5.1, 95% CI: 1.1 – 22.8, p=0.03).

Conclusion: Patients improve outcomes with any type of educational materials (either DVD or booklet) up to 6 months after being informed. Greater improvements with the use of MM-PtET compared to booklet were seen among Spanish-speakers, females, and those with inadequate health literacy.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-randomized-controlled-trial-to-evaluate-a-multimedia-patient-education-tool-in-patients-with-knee-osteoarthritis-six-month-results/