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 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2015

Open Access 01-12-2015 | Research article

Internet based patient education improves informed consent for elective orthopaedic surgery: a randomized controlled trial

Authors: Andrew Fraval, Janan Chandrananth, Yew M Chong, Phong Tran, Lillian S Coventry

Published in: BMC Musculoskeletal Disorders | Issue 1/2015

Login to get access

Abstract

Background

Obtaining informed consent is an essential step in the surgical pathway. Providing adequate patient education to enable informed decision making is a continued challenge of contemporary surgical practice. This study investigates whether the use of a patient information website, to augment patient education and informed consent for elective orthopaedic procedures is an effective measure.

Methods

A randomised controlled trial was conducted comparing the quality of informed consent provided by a standard discussion with the treating surgeon compared to augmentation of this discussion with an online education resource (www.​orthoanswer.​org). Participants were recruited from orthopaedic outpatient clinics. Patients undergoing five common orthopaedic procedures were eligible to participate in the trial. The primary outcome measure was knowledge about their operation. Satisfaction with their informed consent and anxiety relating to their operation were the secondary outcome measures.

Results

There was a statistically significant increase in patient knowledge for the intervention arm as compared to the control arm (p < 0.01). Patients in the intervention arm, had an average score of 69.25% (SD 14.91) correct answers as compared to 47.38% (SD 17.77) in the control arm. Satisfaction was also improved in the intervention arm (p = 0.043). There was no statistically significant difference between the control and intervention arm relating to their anxiety scores (p = 0.195).

Conclusions

The use of a patient education website as an augment to informed consent improves patient knowledge about their planned operation as well as satisfaction with the consent process whilst not increasing their anxiety levels. We recommend that all patients be directed to web based education tools to augment their consent.

Trial registration

Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12614001058​662.
Literature
1.
Kinnersley P, Phillips K, Savage K, Kelly MJ, Farrell E, Morgan B, et al. Interventions to promote informed consent for patients undergoing surgical and other invasive healthcare procedures. Cochrane Database Syst Rev. 2013;7:CD009445. 23832767PubMed
2.
Mulsow JJ, Feeley TM, Tierney S. Beyond consent--improving understanding in surgical patients. Am J Surg. 2012;203(1):112–20. 10.1016/j.amjsurg.2010.12.010, 21641573CrossRefPubMed
3.
Lavelle-Jones C, Byrne DJ, Rice P, Cuschieri A. Factors affecting quality of informed consent. BMJ. 1993;306(6882):885–90. 10.1136/bmj.306.6882.885, 1677345, 1:STN:280:DyaK3s3lsl2qug%3D%3D, 8490411CrossRefPubMedPubMedCentral
4.
Raper SE, Sarwer DB. Informed consent issues in the conduct of bariatric surgery. Surg Obes Relat Dis. 2008;4(1):60–8. 10.1016/j.soard.2007.09.002, 17974497CrossRefPubMed
5.
Atrey A, Gupte CM, Corbett SA. Review of successful litigation against english health trusts in the treatment of adults with orthopaedic pathology: clinical governance lessons learned. J Bone Joint Surg Am. 2010;92(18):e36. 10.2106/JBJS.J.00277, 21159982CrossRefPubMed
6.
Schattner A, Bronstein A, Jellin N. Information and shared decision-making are top patients' priorities. BMC Health Serv Res. 2006;6:21. 10.1186/1472-6963-6-21, 1431526, 16507096CrossRefPubMedPubMedCentral
7.
Schenker Y, Fernandez A, Sudore R, Schillinger D. Interventions to improve patient comprehension in informed consent for medical and surgical procedures: a systematic review. Med Decis Making. 2011;31(1):151–73. 10.1177/0272989X10364247, 20357225CrossRefPubMed
8.
9.
Arozullah AM, Yarnold PR, Bennett CL, Soltysik RC, Wolf MS, Ferreira RM, et al. Development and validation of a short-form, rapid estimate of adult literacy in medicine. Med Care. 2007;45(11):1026–33. 10.1097/MLR.0b013e3180616c1b, 18049342CrossRefPubMed
10.
Miller CK, O'Donnell DC, Searight HR, Barbarash RA. The deaconess informed consent comprehension test: an assessment tool for clinical research subjects. Pharmacotherapy. 1996;16(5):872–8. 1:STN:280:DyaK2s%2Fkt1yrtg%3D%3D, 8888082PubMed
11.
Nguyen TD, Attkisson CC, Stegner BL. Assessment of patient satisfaction: development and refinement of a service evaluation questionnaire. Eval Program Plann. 1983;6(3–4):299–313. 10.1016/0149-7189(83)90010-1, 1:STN:280:DyaL2c3mtFOitQ%3D%3D, 10267258CrossRefPubMed
12.
Barnes LLB, Harp D, Jung WS. Reliability generalization of scores on the spielberger state-trait anxiety inventory. Educ Psychol Meas Aug. 2002;62:603–18. 10.1177/0013164402062004005CrossRef
13.
Cornoiu A, Beischer AD, Donnan L, Graves S, de Steiger R. Multimedia patient education to assist the informed consent process for knee arthroscopy. ANZ J Surg. 2011;81(3):176–80. 10.1111/j.1445-2197.2010.05487.x, 21342392CrossRefPubMed
14.
Mauffrey C, Prempeh EM, John J, Vasario G. The influence of written information during the consenting process on patients' recall of operative risks. A prospective randomised study. Int Orthop. 2008;32(4):425–9. 10.1007/s00264-007-0361-6, 2532278, 1:STN:280:DC%2BD1cvhtFClsg%3D%3D, 17450358, Epub 2007 Apr 21.CrossRefPubMed
15.
Fraval A, Ming Chong Y, Holcdorf D, Plunkett V, Tran P. Internet use by orthopaedic outpatients - current trends and practices. Australas Med J. 2012;5(12):633–8. 10.4066/AMJ.2012.1530, 3561591, 23382767CrossRefPubMedPubMedCentral
16.
Chong YM, Fraval A, Chandrananth J, Plunkett V, Tran P. Assessment of the quality of web-based information on bunions. Foot Ankle Int. 2013;34(8):1134–9. 10.1177/1071100713481458, 23478888CrossRefPubMed
17.
Sambandam SN, Ramasamy V, Priyanka P, Ilango B. Quality analysis of patient information about knee arthroscopy on the World Wide Web. Arthroscopy. 2007;23(5):509–13. 10.1016/j.arthro.2006.12.007, 17478282, e2.CrossRefPubMed
18.
Starman JS, Gettys FK, Capo JA, Fleischli JE, Norton HJ, Karunakar MA. Quality and content of Internet-based information for ten common orthopaedic sports medicine diagnoses. J Bone Joint Surg Am. 2010;92(7):1612–8. 10.2106/JBJS.I.00821, 20595567CrossRefPubMed
19.
Barkin JS, Aronson JK, Feldman LS, Maddern GJ, Strasberg SM. Evaluation and stages of surgical innovations. Lancet. 2009;374:1089–96. 10.1016/S0140-6736(09)61083-7CrossRef
20.
Akkad A, Jackson C, Kenyon S, Dixon-Woods M, Taub N, Habiba M. Patients' perceptions of written consent: questionnaire study. BMJ. 2006;333:528. 10.1136/bmj.38922.516204.55, 1562474, 16880192CrossRefPubMedPubMedCentral
21.
Astley CM, Chew DP, Aylward PE, Molloy DA, De Pasquale CG. A randomised study of three different informational AIDS prior to coronary angiography, measuring patient recall, satisfaction and anxiety. Heart Lung Circ. 2008;17(1):25–32. 10.1016/j.hlc.2007.04.008, 17553747, Epub 2007 Jun 5.CrossRefPubMed
Metadata
Title
Internet based patient education improves informed consent for elective orthopaedic surgery: a randomized controlled trial
Authors
Andrew Fraval
Janan Chandrananth
Yew M Chong
Phong Tran
Lillian S Coventry
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2015
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-015-0466-9

Other articles of this Issue 1/2015

BMC Musculoskeletal Disorders 1/2015 Go to the issue

Research article

Does a minimal invasive approach reduce anterior chest wall numbness and postoperative pain in plate fixation of clavicle fractures?

Research article

How much do rheumatologists and orthopaedists doctors’ modalities impact the cost of arthritis in Cyprus?

Research article

Physical activity and health-related quality of life in chronic low back pain patients: a cross-sectional study

Research article

Surgical management of hallux valgus and hallux rigidus: an email survey among Swiss orthopaedic surgeons regarding their current practice

Erratum

Erratum to: Macroscopic and microscopic assessments of the glenohumeral and subacromial synovitis in rotator cuff disease

Research article

Hip arthroscopy for the management of osteoid osteoma of the acetabulum: a systematic review of the literature and case report