Health-care providers and patients differ on views of knee replacement

January 7, 2009

Total knee replacement (TKR) is a common treatment for osteoarthritis, a disease affecting more than 20 million Americans. However, the surgery poses risks and both patients and physicians must carefully assess its potential benefits and harm. Studies have shown that doctor-patient communication is correlated with outcomes and that patient satisfaction and commitment to treatment are usually higher when the doctor and patient are able to agree on a number of factors. However, despite the increased emphasis on informed decision making, few studies have examined communication factors affecting the decision to have joint replacement surgery.

A new study examined whether communication factors affect health care providers and patient agreement on the need for, risks of and benefits of TKR and whether this agreement predicted patient satisfaction and the intent to follow the treatment recommendations. The study was published in the January issue of Arthritis & Rheumatism (Arthritis Care & Research) (www3.interscience.wiley.com/journal/77005015/home).

Led by Richard L. Street, Jr. of Texas A&M University, the study involved 27 health care providers and 74 patients with severe osteoarthritis. The results showed that in almost one in five encounters, providers and patients differed on whether they thought TKR was recommended or not. Although providers and patients mostly agreed on the importance of TKR and its potential benefits, there were considerable differences regarding the severity of the patient's condition and concerns about complications, with providers generally seeing these as less serious issues than patients did.

The study also showed some evidence that patients were more satisfied with their care and were more likely to follow treatment recommendations when they were more in agreement with their providers on whether they would benefit from TKR.

"Discrepancies in provider-patient beliefs about the risks, benefits and need for TKR are not only a barrier to informed decision making, but such differences also can affect postconsultation outcomes," the authors state. While patients and providers in the study may have spent considerable time discussing the nature of TKR, they may not have adequately discussed the need for the surgery in the first place. The authors note that decision making can be improved by communication that includes more active patient participation, greater agreement on the severity of the patient's arthritis and more agreement on the benefits of TKR. "More research is needed on effective information giving so that all the requirements of informed decision making are met," they state.

Article: "(Mis)Understanding in Patient-Health Care Provider Communication About Total Knee Replacement," Richard L. Street, Jr., Marsha N. Richardson, Vanessa Cox, Maria E. Suarez-Almazor, Arthritis & Rheumatism (Arthritis Care & Research), January 2009; 61:1; pp. 100-107.

Source: Wiley

Explore further: Bone-fracture puzzles introduce undergraduates to real-world engineering

Related Stories

NIST PET phantoms bring new accuracy to medical scans

July 29, 2015

Teaming with a medical equipment company, researchers at the National Institute of Standards and Technology (NIST) have demonstrated the first calibration system for positron emission tomography (PET) scanners directly tied ...

The future of artificial intelligence

July 7, 2015

Only a few years ago, it would have seemed improbable to assume that a piece of technology could quickly and accurately understand most of what you say – let alone translate it into another language.

Recommended for you

How the finch changes its tune

August 3, 2015

Like top musicians, songbirds train from a young age to weed out errors and trim variability from their songs, ultimately becoming consistent and reliable performers. But as with human musicians, even the best are not machines. ...

Machine Translates Thoughts into Speech in Real Time

December 21, 2009

(PhysOrg.com) -- By implanting an electrode into the brain of a person with locked-in syndrome, scientists have demonstrated how to wirelessly transmit neural signals to a speech synthesizer. The "thought-to-speech" process ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.