This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
Osteoarthritis is a disease that breaks down the tissue at the ends of bones in joints. Without this tissue, bones in the knee, hip or other joints can rub together and cause pain. Patients who have knee or hip pain often face the decision of whether to have joint replacement surgery. This surgery replaces damaged bone and tissue with artificial parts and can help patients feel better and become more active. But surgery can also cause problems and recovery may take weeks or months. Because of these downsides, some patients want to delay surgery as long as possible. However, other patients want to have surgery quickly after a doctor offers the option.
Doctors think about many factors when they suggest surgery, such as a patient’s pain level. They also look at the patient’s activity level and the amount of joint damage on the patient’s x-rays. It’s also important for doctors to find out whether a patient wants to have surgery. Research shows that doctors don’t always find out what option a patient prefers.
Researchers are comparing two decision aids designed to help patients decide whether joint replacement surgery is the best choice for them. Decision aids help people choose between two or more healthcare options based on what is most important to them. Researchers want to know whether patients are more likely to get the treatment they want if they use a decision aid. Researchers also want to know if patients are more likely to get the treatment they want if their doctors understand patients’ goals.
A group of patients are serving as advisors for this study. These patients are helping choose the decision aids being tested. Orthopedic surgeons, primary care providers, nurses, and hospital administrators are also helping design and carry out the study.
Who can this research help?
Findings from this study can help researchers and doctors choose how to involve patients in making decisions about joint replacement surgery. This study can help patients make informed decisions and get the treatments they want.
What is the research team doing?
The research team is recruiting 1,120 patients who have osteoarthritis in the hip or knee. Researchers are assigning patients by chance to receive one of two decision aids before meeting with a doctor to talk about treatment options. One decision aid is a long, detailed video and booklet. This decision aid includes information about the benefits and harms of surgery and other treatment options. The video includes interviews with patients and doctors, who talk about their experiences with treatments for hip and knee pain, including surgery.
Researchers are also testing a second decision aid that is much shorter. This decision aid is a brief booklet that lists the key facts about joint replacement surgery. The booklet has quizzes and worksheets to help patients choose the best treatment option for them. Both decision aids are available online to the study participants.
Researchers are assigning half of the doctors by chance to get a report with information from the patients using the decision aids about their goals and treatment preferences. The research team wants to see if giving doctors information about patients’ goals will make it likely that doctors will consider these goals when they make treatment recommendations.
Patients fill out surveys at three points during the study: before visiting the doctor, one week after visiting the doctor, and 6 to 12 months later. These surveys measure what patients know about their condition. The surveys ask patients about their preferred treatment and about whether they reviewed the decision aid. The survey also asks patients about their quality of life and whether they had surgery.
Researchers want to know whether decision aids help patients learn about their treatment options. Researchers also want to know how many patients get the treatment they want and how decision aids can help patients make their own choices in the future.