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Shared decision-making linked with improved patient satisfaction, outcomes

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SAN DIEGO — Better outcomes and higher patient-satisfaction rates were seen for patients who were well-informed and decided on treatment with their orthopedic surgeons, according to results presented, here.

“We are committed to improving outcomes after surgical procedures,” co-author Harry E. Rubash, MD, emeritus chief of the Department of Orthopedic Surgery at Massachusetts General Hospital and Edith M. Ashley professor of orthopedic surgery at Harvard Medical, said in a release from the American Academy of Orthopaedic Surgeons. “This study found that surgical patients who are more informed and have a clear preference for surgery, have better outcomes. It highlights the need to focus further on decision-making prior to elective surgeries and other treatments.”

Rubash and his colleagues performed a prospective study of 550 patients with knee or hip osteoarthritis, herniated discs or lumbar spinal stenosis. After first visit with a specialist, patients were sent a survey a week later by mail which evaluated patients’ knowledge, preferred treatment and baseline quality of life (QoL). Patients were sent another survey that assessed treatment, QoL, regret regarding their treatment choice and satisfaction 6 months after either non-surgical or surgical treatment. Investigators used regression analyses to test whether patients who made informed, patient-centered decisions would have greater QoL, higher satisfaction and fewer decision regrets at follow-up.

According to the study abstract, the first survey had a 70.3% response rate and the follow-up survey had an 85% response rate. Within 6 months of the initial visit, 49% of patients had surgery. Rubash and colleagues noted one-third of patients met the informed, patient-centered decision criteria and these patients had significantly greater disease-specific and overall QoL.

According to researchers, patients in the patient-centered decision group had greater chances of being extremely satisfied with pain relief, being very or extremely satisfied with treatment and with having less regret. – by Monica Jaramillo

References:

Sepucha K, et al. Poster #126. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 14-18, 2017; San Diego.

www.aaos.org

Disclosure : Rubash reports he receives intellectual property royalties from CeramTec.