Internet Versus DVD Decision Aids for Hip and Knee Osteoarthritis

被引:17
作者
Allen, Kelli D. [1 ,2 ,3 ]
Sanders, Linda L. [1 ,4 ]
Olsen, Maren K. [1 ,5 ]
Bowlby, Lynn [4 ]
Katz, Jeffrey N. [6 ,7 ]
Mather, Richard C., III [8 ]
Williams, John W., Jr. [1 ,4 ]
机构
[1] Durham VA Med Ctr, Hlth Serv Res & Dev Serv, Durham, NC USA
[2] Univ N Carolina, Dept Med, Chapel Hill, NC USA
[3] Univ N Carolina, Thurston Arthrit Res Ctr, Chapel Hill, NC USA
[4] Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA
[5] Duke Univ, Dept Biostat & Bioinformat, Durham, NC USA
[6] Brigham & Womens Hosp, Dept Orthoped Surg, 75 Francis St, Boston, MA 02115 USA
[7] Brigham & Womens Hosp, Dept Med Rheumatol Immunol & Allergy, 75 Francis St, Boston, MA 02115 USA
[8] Duke Univ, Dept Orthopaed Surg, Durham, NC USA
关键词
Osteoarthritis; decision making; patient education;
D O I
10.1002/msc.1116
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: Decision aids (DAs) can improve multiple decision-making outcomes, but it is not known whether different formats of delivery differ in their effectiveness or acceptability. The present study compared the effectiveness and acceptability of internet and DVD formats of DAs for osteoarthritis (OA). Methods: Patients with hip or knee OA were randomized to view an internet or DVD format DA, which provided information on OA treatments. Measures were collected at baseline, immediately after viewing the DA and then 30 days later. Outcomes included: Hip/Knee OA Decision Quality Instrument - Knowledge Subscale (HK-DQI Knowledge), Decisional Conflict Scale (DCS), Preparation for Decision Making Scale (PDMS), Stage of Decision Making, and Acceptability of DAs. Generalized estimating equations (GEE) were used to examine changes in HK-DQI Knowledge and DCS scores over time, between decision aid groups and within the sample overall. Group differences in the PDMS scale (assessed once, immediately after DA viewing) were estimated using a Wilcoxon rank sums test. Results: Among 155 participants in the study, the mean age was 61.8 years, 60.6% were women and 58.1% were Caucasian. HK-DQI Knowledge scores improved over time (p< 0.001), although there was some attenuation by the 30-day follow-up; there was no difference between the two DA groups (p = 0.448). DCS scores decreased markedly for both groups (p< 0.001) and improvements were maintained by the 30-day follow-up (means: internet: baseline = 25.0, 30-day = 6.9; DVD: baseline = 25.0, 30-day = 6.2); there was no difference between the two DA groups (p = 0.808). PDMS scores were higher for the DVD group than the internet group (85.2 versus 74.9, p = 0.005). Stage of Decision Making became more certain after viewing the DA for both groups, with even more certainty indicated at 30-day follow-up. Acceptability items indicated positive perceptions of both DAs. Discussion: Internet and DVD DAs were associated with meaningful, comparable improvements in decision-making outcomes in patients with knee and hip OA. DAs are inexpensive to disseminate and could be valuable tools for enhancing care for OA. Copyright (C) 2015 John Wiley & Sons, Ltd.
引用
收藏
页码:87 / 97
页数:11
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