Well-informed patients who contribute to shared decision-making (SDM) with their surgeons have better outcomes and higher patient satisfaction rates, suggests a study presented recently at the AAOS Annual Meeting.
As defined in a media release from the American Association of Orthopaedic Surgeons, SDM is a process in which doctors and patients work together to make decisions and select tests, treatments and care plans based on clinical evidence (imaging and test results) that balances risks and expected outcomes with patient preferences and values.
Researchers analyzed results from surveys and questionnaires that included more than 550 respondents (average age: 63.9) with hip or knee osteoarthritis, a slipped or ruptured (herniated) disc in the lower back, or lumbar spinal stenosis.
An initial survey assessed the patient’s knowledge of their condition, preferred treatment (surgical or nonsurgical), baseline quality of life, physical movement capabilities and level of pain. A follow-up survey was administered six months after the initial office visit to patients who had nonsurgical treatment, and six months after surgery for those who had surgery. The follow-up questionnaires focused on treatment, quality of life, regret over their treatment choice and treatment outcomes, the release explains.
One-third of the respondents were deemed IPC, meaning they understood their condition well, received their preferred treatment, and made an informed patient-centered decision.
In the follow-up assessment, the IPC patients had higher scores related to overall and disease-specific quality of life outcomes. They also were more likely to be extremely satisfied with their pain management plan (76.7% versus 41.9%), very or extremely satisfied with their treatment (70.7% versus 34.7%), and had less regret with their treatment decision (5.2% versus 15%).
“This study is unique in its evaluation of the implementation of a shared decision-making process as part of a real world orthopaedic elective surgical practice,” says co-study author Thomas Cha, MD, MBA, assistant chief of surgery at the Orthopaedic Spine Center at Massachusetts General Hospital, and an instructor at Harvard Medical School. “Shared decision-making did not just result in better patient experience ratings, but also improved patient outcomes.”
Co-author Harry Rubash, MD, emeritus chief of the Department of Orthopaedic Surgery at Massachusetts General Hospital and the Edith M. Ashley professor of orthopaedic surgery at Harvard Medical School, adds that the study “highlights the need to focus further on decision-making prior to elective surgeries and other treatments.”
[Source(s): American Academy of Orthopaedic Surgeons, PR Newswire]