Impact of patient decision aids on appropriate and timely access to hip or knee arthroplasty for osteoarthritis: a randomized controlled trial

摘要: Summary Objective To evaluate the effectiveness of patient decision aids (PtDA) compared to usual education on appropriate and timely access total joint arthroplasty in patients with osteoarthritis. Method A randomized controlled trial (RCT) undergoing orthopedic screening. Control intervention arms received education; arm also a PtDA surgeon preference report. Wait times (primary outcome) were described using stratified Kaplan–Meier survival curves censored at time death or loss follow-up, multivariable Cox proportional hazards regression. Secondary outcomes Cochran-Mantel-Haenszel chi-squared tests. Results 343 ( n  = 174) control  = 169). The typical was 66 years old, retired, living someone, 51% had high school less. associated trend towards reduction wait (hazard ratio (HR) 1.25, 95% confidence interval (CI) 0.99–1.60, P  = 0.0653). Median 3 weeks shorter than community site no difference academic site. Good quality reached by 56.1% 44.5% (Relative risk (RR) 1.25; CI 1.00–1.56,  = 0.050). Surgery rates 73.2% 80.5% controls (RR 0.91: 0.81–1.03) 12 (7.3%) eight participants (4.9%) returning have surgery within 2  = 0.791). Conclusion Compared controls, aid recipients one site, fewer surgeries, more likely reach good quality, but overall effect not statistically significant. Trials registration full protocol is available ClinicalTrials.Gov (NCT00911638).