Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Patient-engaged research can improve the safety and satisfaction outcomes of hip and knee arthroplasty (joint replacement surgery). Patients are able to identify the decisions that are most important to them when undergoing hip and knee arthroplasty and the factors they view as important in making those decisions.
Methods: Forty-nine participants were recruited from ArthritisPower Patient-Powered Research Network and CreakyJoints patient community to participate in structured one-hour discussions held via webinar during January to April 2016 to understand patient experience with joint replacement. Patients described decisions that were most important to them and the factors they used to make those decisions. Discussions were transcribed and coded to identify themes; patient decisions and factors were identified and categorized; and co-occurrence of decisions with factors was tabulated. Demographic and procedure-related characteristics were captured.
Results: Seven decisions emerged that were influenced by at least ten factors (Table). The most important decisions involved whether to have surgery, selection of surgery date, surgeon, facility, implant device, and ancillary health care professionals (HCPs) and services. Factors included current situation, expectations of having or not having surgery, professional and word-of-mouth familiarity with surgeon/HCP, procedure, services and device, and perceived value. Patients’ current situation and health status and their expectations of surgery were most commonly used to make decisions about whether and when to have surgery. Patients’ trust of and communication with doctors was the most commonly used factor when deciding on arthroplasty surgeon.
Conclusion: Arthroplasty patients are concerned about a variety of decisions. Patient-centered research should maximally address questions of importance to patients and this study is a first step in identifying and prioritizing topics that matter most to patients and the information that patients currently use to make joint replacement decisions. Table: Arthroplasty Decisions Important to Patients and the Most Common Factors Influencing Them
Decisions Important to Patients
Most Common Factors Influencing Decisions
|Surgery: Whether to have partial or total hip/knee joint replacement surgery (arthroplasty)||Current life situation and health status (44%), Expectations of having surgery (11%), Expectations of NOT having surgery (11%), Information provided to patient by doctor or other HCP (11%), Alternatives to surgery that have been tried or are known about (11%)|
|Timing: When to have surgery||Current life situation and health status (38%), Expectations of having surgery (19%), Alternatives to surgery that have been tried or are known about (19%), Expectations of NOT having surgery (8%)|
|Surgeon: Which surgeon will perform surgery||Trust and communication with surgeon (45%), Perceived value of surgeon’s expertise (19%), Expectations of having surgery (16%), Information accessed by patient autonomously (10%)|
|Facility: Where surgery will be performed (e.g., geographic location, specific hospital or medical center)||Information provided to patient by doctor or other HCP (28%), Trust and communication with HCP (18%), Firsthand familiarity with facility (18%), Expectations of having surgery (18%), Information accessed by patient autonomously (9%), Perceived value of facility expertise (9%)|
|Device: Which implant device will be installed during surgery||Expectations of having surgery (39%), Information provided to patient by doctor or other HCP (18%), Perceived value of device (16%), Trust and communication with HCP (11%)|
|Other HCPs: Who/which other health care professionals (HCPs) besides the surgeon will be involved in care during and after surgery (e.g., anesthesiologist, physical therapist)||Expectations of having surgery (30%), Trust and communication with HCP (20%), Current life situation and health status (20%), Perceived value of other HCPs (20%), Firsthand familiarity with other HCPs (10%)|
|Other Services: What other services will be necessary before, during or after surgery (e.g., mental health)||Expectations of having surgery (71%), Trust and communication with HCP (14%), Current life situation and health status (14%)|
To cite this abstract in AMA style:Nowell WB, Venkatachalam S, Harden E, Concannon T. Patient Decisions Related to Hip and Knee Arthroplasty and the Factors Influencing Them [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/patient-decisions-related-to-hip-and-knee-arthroplasty-and-the-factors-influencing-them/. Accessed February 26, 2020.
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