Shared Decision-Making Is Associated with Better Outcomes in Patients with Knee But Not Hip Osteoarthritis: The
Karen R Sepucha1,2, Ha Vo1, Yuchiao Chang1,2
1Massachusetts General Hospital, Boston, Massachusetts.
The Journal of Bone and Joint Surgery. American Volume
|August 26, 2021
Summary
High-quality, informed, patient-centered (IPC) decisions improved health outcomes and satisfaction for knee replacement patients. However, IPC decisions did not benefit hip replacement patients, showing varied impacts of shared decision-making.
Area of Science:
- Orthopedic Surgery
- Health Services Research
- Decision Science
Background:
- Shared surgical decision-making is recommended but its impact on patient outcomes is unclear.
- This study investigated if informed, patient-centered (IPC) decisions improve outcomes for knee and hip replacement candidates.
Purpose of the Study:
- To determine if high-quality, informed, patient-centered (IPC) decisions lead to better health outcomes, satisfaction, and less decision regret.
- To compare outcomes between patients making IPC decisions versus lower-quality decisions.
Main Methods:
- A multisite randomized study involving 854 patients with hip and knee osteoarthritis.
- Data collected on decision-making and health outcomes at baseline and 6 months post-treatment.
- Linear and logistic regression models used to analyze associations between IPC decisions and outcomes.
Main Results:
- 68% of patients made IPC decisions. The IPC group showed significant improvements in quality of life.
- For knee osteoarthritis patients, IPC decisions were linked to better functional scores, higher satisfaction, improved pain relief, and less regret.
- For hip osteoarthritis patients, IPC decisions were not associated with improved functional scores or satisfaction and were linked to increased regret.
Conclusions:
- Informed, patient-centered decisions positively impact health outcomes and satisfaction for knee osteoarthritis patients.
- The benefits of informed, patient-centered decision-making were not observed in hip osteoarthritis patients in this study.
- Decision quality influences outcomes differently based on the joint affected in osteoarthritis.
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