Patient Decision Aids in Joint Replacement Surgery: A Literature Review and An Opinion Survey of Consultant Orthopaedic Surgeons

Department of Medical Oncology, Northern Centre for Cancer Treatment, Newcastle General Hospital, Newcastle upon Tyne, UK.
Annals of The Royal College of Surgeons of England (Impact Factor: 1.22). 05/2008; 90(3):198-207. DOI: 10.1308/003588408X285748
Source: PubMed

ABSTRACT Patient decision aids could facilitate shared decision-making in joint replacement surgery. However, patient decision aids are not routinely used in this setting.
With a view to developing a patient decision aid for UK hip/knee joint replacement practice, we undertook a systematic search of the literature for evidence on the use of shared decision-making and patient decision aids in orthopaedics, and a national survey of consultant orthopaedic surgeons on the potential acceptability and feasibility of patient decision aids.
We found little published evidence regarding shared decision-making or patient decision aids in orthopaedics. In the survey, 362 of 639 (57%) randomly selected consultant orthopaedic surgeons responded. Respondents appear representative of consultant orthopaedic surgeons in the UK. Of 272 valid responses, 79% (95% CI, 73-85%) thought patient decision aids a good or excellent idea. There was consensus on the potential helpfulness of patient decision aids and core content. A booklet to take home was the preferred medium/practice model.
Despite the increased emphasis on patient involvement in decision-making, there is little evidence in the medical literature relating to shared decision-making or the use of patient decision aids in orthopaedic surgery. Further research in this area of clinical practice is required. Our survey shows that consultant orthopaedic surgeons in the UK are generally positive about the use of patient decision aids for joint replacement surgery. Survey results could inform future development of patient decision aids for joint replacement practice in the UK.

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    • "Given the complexity and variability of information, it is not surprising that many patients do not feel well informed about possible outcomes of surgical intervention. It has been well documented that education increases patient satisfaction with decision making [2] [3] [4] [5]. The internet has the potential to provide patients with information and support as an adjunct to direct communication with the surgeon [6] [7] [8]. "
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