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?
Hip and knee arthritis are the most common causes of disability in the United States. These types of arthritis affect more than two-thirds of adults over the age of 65. When medicine and physical therapy no longer help with arthritis pain and disability, many patients think about having joint replacement surgery. However, it is hard for patients to know how they will benefit from surgery or what the risks of surgery are for them.
Decision aids help people choose between two or more healthcare options based on what is most important to them. In this study, the research team is creating and testing a web-based decision aid to help patients figure out their treatment goals and choose a treatment. For example, some patients may want to have less pain or be more active. The team wants to see if patients who use the decision aid feel more satisfied with their decisions and have less pain than patients who don’t use it.
Patients note that support from peers who have thought about joint replacement is important when choosing an arthritis treatment, as well as support from their doctors. The research team wants to compare how the decision aid works for patients who receive peer support in addition to the decision aid versus for those who use the decision aid alone.
Who can this research help?
Findings from this study may help doctors and surgeons decide whether to offer the decision aid to help patients choose an arthritis treatment.
What is the research team doing?
The research team is carrying out this study with a network of orthopedic surgeons in several states. The study has two parts. In the first part, the team is assigning surgeons by chance to provide either the decision aid or usual care. In the usual care group, doctors and patients talk about patients’ knee pain and activities. They also talk about risk factors, such as smoking, and about whether surgery is the best choice. In the decision aid group, the decision aid helps patients understand the benefits and risks of different arthritis treatments. It also creates a personalized report that patients can discuss with their surgeons and primary care doctors. After each patient meets with a surgeon, the team sends copies of the report to the patient’s regular doctor.
In the second part of the study, the research team is assigning surgeons by chance to provide patients with either the decision aid plus a peer support website or the decision aid alone.
The research team is comparing patients’ satisfaction with their treatment between groups. They are also comparing patients’ pain, symptoms, quality of life, and ability to move and exercise after treatment.
Patients, orthopedists, physical therapists, and clinicians help design and test the decision aid.
Research methods at a glance
|Design||Cluster randomized controlled trial|
|Population||English-speaking adults age 18 and older who are seeking care at participating surgeons’ practices for knee or hip osteoarthritis (OA)|
Primary: satisfaction with treatment decisions, pain relief at 6 months
Secondary: functional gain, pain relief at 12 months
|6-month follow-up for primary outcomes|
Related Journal Citations
Patient / Caregiver Partners
- Ronald Scott
- Allison Ripa
- Hazel and Richard DeNeeza
- Meg Waldron-Evers, Citizens for Patient Safety, LLC
- Warren Ferguson, MD
- Joanne Calista, Area Health Education Center
Other Stakeholder Partners
- FORCE-TJR orthopedic surgeon network
- FORCE-TJR Stakeholder Committee
- Carol Oatis, PT, PhD
- Ewa Roos, PT, PhD
^This project was originally affiliated with the University of Massachusetts Medical School