A randomized controlled trial of patient recall after detailed written consent versus standard verbal consent in adults with routine orthopaedic trauma

Aims Patient decision aids have previously demonstrated an improvement in the quality of the in-formed consent process. This study assessed the effectiveness of detailed written patient in-formation, compared to standard verbal consent, in improving postoperative recall in adult orthopaedic trauma patients.Methods This randomized controlled feasibility trial was conducted at two teaching hospitals with-in the South Eastern Sydney Local Health District. Adult patients (age >= 18 years) pending orthopaedic trauma surgery between March 2021 and September 2021 were recruited and randomized to detailed or standard methods of informed consent using a random sequence concealed in sealed, opaque envelopes. The detailed group received procedure-specific writ-ten information in addition to the standard verbal consent. The primary outcome was total recall, using a seven -point interview-administered recall questionnaire at 72 hours postoper-atively. Points were awarded if the participant correctly recalled details of potential compli-cations (maximum three points), implants used (maximum three points), and postoperative instructions (maximum one point). Secondary outcomes included the anxiety subscale of the Hospital and Anxiety Depression Scale (HADS- A) and visual analogue scale (VAS) for pain collected at 24 hours preoperatively and 72 hours postoperatively. Additionally, the Patient Satisfaction Questionnaire Short Form (PSQ- 18) measured satisfaction at 72 hours postoperatively.Results A total of 60 patients were randomized, 32 to the standard group and 28 to the detailed group. Patients in the detailed group had significantly higher total recall score compared to the standard group (mean difference 1.29 points (95% confidence interval (CI) 0.51 to 2.08); p = 0.002). There were no differences in HADS- A (mean difference 0.39 (95% CI-2.11 to 2.88); p = 0.757), VAS pain (mean difference 5.71 (95% CI-22.25 to 11.11); p = 0.499), or PSQ- 18 (mean difference 0.499; 95% CI-1.6 to 3.42; p = 0.392).Conclusion Detailed written tools are useful in improving postoperative recall in adult orthopaedic trau-ma patients.