Background Patient-engaged research can improve the safety and satisfaction outcomes of hip and knee arthroplasty (joint replacement surgery).
Objectives The objective of this study was to identify the decisions that are most important to patients when undergoing hip or knee arthroplasty and the factors they view as important in making those decisions.
Methods Forty-nine U.S. participants were recruited from ArthritisPower Patient-Powered Research Network and CreakyJoints arthritis patient community to participate in structured one-hour discussions held via webinar during January to April 2016 to understand patients' experiences 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 and factors was tabulated. Demographic and procedure-related characteristics were captured.
Results Eight 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 factor used when deciding on arthroplasty surgeon.
Conclusions 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.
Acknowledgements This project was funded through a Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award (2228-GHLF).
Disclosure of Interest None declared
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