Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Medical Informatics and Decision Making
Published in: BMC Medical Informatics and Decision Making 1/2020

Open Access 01-12-2020 | Knee Osteoarthritis | Research article

Preparing for an orthopedic consultation using an eHealth tool: a randomized controlled trial in patients with hip and knee osteoarthritis

Authors: Aniek A. O. M. Claassen, Henk J. Schers, Vincent J. J. F. Busch, Petra J. C. Heesterbeek, Frank H. J. van den Hoogen, Thea P. M. Vliet Vlieland, Cornelia H. M. van den Ende

Published in: BMC Medical Informatics and Decision Making | Issue 1/2020

Login to get access

Abstract

Background

To evaluate the effect of a stand-alone mobile and web-based educational intervention (eHealth tool) compared to usual preparation of a first orthopedic consultation of patients with hip or knee osteoarthritis (OA) on patients’ satisfaction.

Methods

A two-armed randomized controlled trial involving 286 patients with (suspicion of) hip or knee OA, randomly allocated to either receiving an educational eHealth tool to prepare their upcoming consultation (n = 144) or usual care (n = 142). Satisfaction with the consultation on three subscales (range 1–4) of the Consumer Quality Index (CQI - primary outcome) and knowledge (assessed using 22 statements on OA, range 0–22), treatment beliefs (assessed by the Treatment beliefs in OsteoArthritis questionnaire, range 1–5), assessment of patient’s involvement in consultation by the surgeon (assessed on a 5-point Likert scale) and patient satisfaction with the outcome of the consultation (numeric rating scale), were assessed.

Results

No differences between groups were observed on the 3 subscales of the CQI (group difference (95% CI): communication 0.009 (− 0.10, 0.12), conduct − 0.02 (− 0.12, 0.07) and information provision 0.02 (− 0.18, 0.21)). Between group differences (95% CI) were in favor of the intervention group for knowledge (1.4 (0.6, 2.2)), negative beliefs regarding physical activities (− 0.19 (− 0.37, − 0.002) and pain medication (− 0.30 (− 0.49, − 0.01)). We found no differences on other secondary outcomes.

Conclusions

An educational eHealth tool to prepare a first orthopedic consultation for hip or knee OA does not result in higher patient satisfaction with the consultation, but it does influence cognitions about osteoarthritis.

Trial registration

Dutch Trial Register (trial number NTR6262). Registered 30 January 2017.
Literature
1.
Fernandes L, Hagen KB, Bijlsma JW, Andreassen O, Christensen P, Conaghan PG, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis. 2013;72(7):1125–35.PubMedCrossRef
2.
3.
Selten EMH, Geenen R, Schers HJ, van den Hoogen FHJ, van der Meulen-Dilling RG, van der Laan WH, et al. Treatment beliefs underlying intended treatment choices in knee and hip osteoarthritis. Int J Behav Med. 2018;25(2):198-206.
4.
du LJ HM, Vuijk D, Rakic A, Haverkamp D. Facing the decision about the treatment of hip or knee osteoarthritis: what are patients' needs? Knee Surg Sports Traumatol Arthrosc. 2016;24(5):1710–6.CrossRef
5.
Barten DJ, Smink A, Swinkels IC, Veenhof C, Schers HJ, Vliet Vlieland TP, et al. Factors associated with referral to secondary Care in Patients with Osteoarthritis of the hip or knee after implementation of a stepped-care strategy. Arthritis Care Res (Hoboken ). 2017;69(2):216–25.CrossRef
6.
McHugh GA, Campbell M, Luker KA. GP referral of patients with osteoarthritis for consideration of total joint replacement: a longitudinal study. Br J Gen Pract. 2011;61(589):e459–68.PubMedPubMedCentralCrossRef
7.
Samsson KS, Bernhardsson S, Larsson ME. "Take me seriously and do something!" - a qualitative study exploring patients' perceptions and expectations of an upcoming orthopaedic consultation. BMC Musculoskelet Disord. 2017;18(1):367.PubMedPubMedCentralCrossRef
8.
Waters S, Edmondston SJ, Yates PJ, Gucciardi DF. Identification of factors influencing patient satisfaction with orthopaedic outpatient clinic consultation: a qualitative study. Man Ther. 2016;25:48–55.PubMedCrossRef
9.
Greene J, Hibbard JH, Sacks R, Overton V. When seeing the same physician, highly activated patients have better care experiences than less activated patients. Health Aff (Millwood ). 2013;32(7):1299–305.CrossRef
10.
Wetzels R, Harmsen M, Van WC, Grol R, Wensing M. Interventions for improving older patients' involvement in primary care episodes. Cochrane Database Syst Rev. 2007;1:CD004273.
11.
Belkora J, Volz S, Loth M, Teng A, Zarin-Pass M, Moore D, et al. Coaching patients in the use of decision and communication aids: RE-AIM evaluation of a patient support program. BMC Health Serv Res. 2015;15:209.PubMedPubMedCentralCrossRef
12.
Shue J, Karia RJ, Cardone D, Samuels J, Shah M, Slover JD. A randomized controlled trial of two distinct shared decision-making aids for hip and knee osteoarthritis in an ethnically diverse patient population. Value Health. 2016;19(4):487–93.PubMedCrossRef
13.
Demiris G, Afrin LB, Speedie S, Courtney KL, Sondhi M, Vimarlund V, et al. Patient-centered applications: use of information technology to promote disease management and wellness. A white paper by the AMIA knowledge in motion working group. J Am Med Inform Assoc. 2008;15(1):8–13.PubMedPubMedCentralCrossRef
14.
Bolle S, van Weert JC, Daams JG, Loos EF, de Haes HC, Smets EM. Online health information tool effectiveness for older patients: a systematic review of the literature. J Health Commun. 2015;20(9):1067–83.PubMedCrossRef
15.
Umapathy H, Bennell K, Dickson C, Dobson F, Fransen M, Jones G, et al. The web-based osteoarthritis management resource my joint pain improves quality of care: a quasi-experimental study. J Med Internet Res. 2015;17(7):e167.PubMedPubMedCentralCrossRef
16.
Schulz KF, Altman DG, Moher D. CONSORT Group. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. Trials. 2010;11:32.PubMedPubMedCentralCrossRef
17.
Kelders SM, Kok RN, Ossebaard HC, Van Gemert-Pijnen JE. Persuasive system design does matter: a systematic review of adherence to web-based interventions. J Med Internet Res. 2012;14(6):e152.PubMedPubMedCentralCrossRef
18.
Smink AJ, van den Ende CH, Vliet Vlieland TP, Swierstra BA, Kortland JH, Bijlsma JW, et al. “Beating osteoARThritis”: development of a stepped care strategy to optimize utilization and timing of non-surgical treatment modalities for patients with hip or knee osteoarthritis. Clin Rheumatol. 2011;30(12):1623–9.PubMedCrossRef
19.
Claassen AAOM, Vliet Vlieland TPM, Busch VJJF, Schers HJ, van den Hoogen FHJ, van den Ende CHM. An electronic health tool to prepare for the first orthopedic consultation: use and usability study. JMIR Form Res. 2019;3(4):e13577.PubMedPubMedCentralCrossRef
20.
Roorda LD, Jones CA, Waltz M, Lankhorst GJ, Bouter LM, van der Eijken JW, et al. Satisfactory cross cultural equivalence of the Dutch WOMAC in patients with hip osteoarthritis waiting for arthroplasty. Ann Rheum Dis. 2004;63(1):36–42.PubMedPubMedCentralCrossRef
21.
Delnoij DM, Rademakers JJ, Groenewegen PP. The Dutch consumer quality index: an example of stakeholder involvement in indicator development. BMC Health Serv Res. 2010;10:88.PubMedPubMedCentralCrossRef
22.
Zuidgeest M, Sixma H, Rademakers J. Measuring patients' experiences with rheumatic care: the consumer quality index rheumatoid arthritis. Rheumatol Int. 2009;30(2):159–67.PubMedCrossRef
23.
Linschoten CP, Barf HA, Moorer P, Spoorenberg S. CQ-index Poliklinische Ziekenhuiszorg: meetinstrumentontwikkeling. ARGO Rijksuniversiteit Groningen BV; 2011.
24.
Meuwissen LE, de Bakker DH. 'Consumer quality'-index 'General practice care' measures patients' experiences and compares general practices with each other. Ned Tijdschr Geneeskd. 2009;153:A180.PubMed
25.
Claassen AAOM, Kremers-van de Hei K, van den FHJ H, van der Laan WH, WHC R, Koeter S, et al. The most important frequently asked questions of patients with hip or knee osteoarthritis: a best-worst scaling exercise. Arthritis Care Res (Hoboken ). 2018.
26.
Selten EMH, Vriezekolk JE, Schers HJ, Nijhof MW, van der Laan WH, van der Meulen-Dilling RG, et al. Development of the "treatment beliefs in knee and hip OsteoArthritis (TOA)" questionnaire. BMC Musculoskelet Disord. 2017;18(1):402.PubMedPubMedCentralCrossRef
27.
Krol MW, De BD, Sixma H, van der Hoek L, Rademakers JJ, Delnoij DM. Patient experiegercances of inpatient hospital care: a department matter and a hospital matter. Int J Qual Health Care. 2015;27(1):17–25.PubMedCrossRef
28.
Timmers T, Janssen L, Pronk Y, van der Zwaard BC, Koeter S, van OD, et al. Assessing the Efficacy of an Educational Smartphone or Tablet App With Subdivided and Interactive Content to Increase Patients' Medical Knowledge: Randomized Controlled Trial. JMIR Mhealth Uhealth. 2018;6(12):e10742.PubMedPubMedCentralCrossRef
29.
Smith TO, Purdy R, Lister S, Salter C, Fleetcroft R, Conaghan PG. Attitudes of people with osteoarthritis towards their conservative management: a systematic review and meta-ethnography. Rheumatol Int. 2014;34(3):299–313.PubMedCrossRef
30.
Mannion AF, Kampfen S, Munzinger U, Kramers-de QI. The role of patient expectations in predicting outcome after total knee arthroplasty. Arthritis Res Ther. 2009;11(5):R139.PubMedPubMedCentralCrossRef
31.
Nilsdotter AK, Toksvig-Larsen S, Roos EM. Knee arthroplasty: are patients' expectations fulfilled? A prospective study of pain and function in 102 patients with 5-year follow-up. Acta Orthop. 2009;80(1):55–61.PubMedPubMedCentralCrossRef
32.
Hamilton DF, Lane JV, Gaston P, Patton JT, Macdonald D, Simpson AH, et al. What determines patient satisfaction with surgery? A prospective cohort study of 4709 patients following total joint replacement. BMJ Open. 2013:3(4).
33.
Noble PC, Conditt MA, Cook KF, Mathis KB. The John Insall award: patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res. 2006;452:35–43.
34.
Dunbar MJ, Richardson G, Robertsson O. I can't get no satisfaction after my total knee replacement: rhymes and reasons. Bone Joint J. 2013;95-B(11 Suppl A):148–52.PubMedCrossRef
35.
Frankel L, Sanmartin C, Conner-Spady B, Marshall DA, Freeman-Collins L, Wall A, et al. Osteoarthritis patients' perceptions of “appropriateness” for total joint replacement surgery. Osteoarthr Cartil. 2012;20(9):967–73..PubMedCrossRef
36.
Stacey D, Legare F, Col NF, Bennett CL, Barry MJ, Eden KB, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2014 Jan 28;1:CD001431.
37.
Tolk JJ, Janssen RPA, Haanstra TM, Bierma-Zeinstra SMA, Reijman M. The EKSPECT study: the influence of expectation modification in knee arthroplasty on satisfaction of PatiEnts: study protocol for a randomized controlled trial. Trials. 2018;19(1):437.PubMedPubMedCentralCrossRef
38.
Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42.PubMedCrossRef
39.
Harrington J, Noble LM, Newman SP. Improving patients’ communication with doctors: a systematic review of intervention studies. Patient Educ Couns. 2004;52(1):7–16.PubMedCrossRef
40.
Simblett S, Greer B, Matcham F, Curtis H, Polhemus A, Ferrao J, et al. Barriers to and facilitators of engagement with remote measurement Technology for Managing Health: systematic review and content analysis of findings. J Med Internet Res. 2018;20(7):e10480.PubMedPubMedCentralCrossRef
41.
Metadata
Title
Preparing for an orthopedic consultation using an eHealth tool: a randomized controlled trial in patients with hip and knee osteoarthritis
Authors
Aniek A. O. M. Claassen
Henk J. Schers
Vincent J. J. F. Busch
Petra J. C. Heesterbeek
Frank H. J. van den Hoogen
Thea P. M. Vliet Vlieland
Cornelia H. M. van den Ende
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2020
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-020-01130-0

Other articles of this Issue 1/2020

BMC Medical Informatics and Decision Making 1/2020 Go to the issue

Research article

Personal decision support for survivor engagement: formulation and feasibility evaluation of a conceptual framework for implementing online cancer survivorship care plans

Research article

The costs outweigh the benefits: seeing side-effects online may decrease adherence to statins

Research article

The use of mobile phone functionalities by patients with asthma and their desire to use for self-care purposes

Research article

A new concordant partial AUC and partial c statistic for imbalanced data in the evaluation of machine learning algorithms

Research article

Examining the quality of record linkage process using nationwide Brazilian administrative databases to build a large birth cohort

Research article

Designing a novel hybrid healthcare teleconsultation network: a benchtop study of telepathology in Iran and a systematic review