Improving informed decision-making for patients with knee pain.
OBJECTIVE
Studies have shown that patients with knee pain are not well informed of their potential treatment options and that patient preferences are often discordant with physician practices. The objective of this pilot study was to test the efficacy of a computer tool to improve informed decision-making for patients with knee pain in an outpatient primary care clinic setting.


METHODS
Patients with knee pain were randomized to receive an information pamphlet or to perform a computer task. The latter was designed to elicit preferences based on patient tradeoffs for route of administration, benefits, and side effects of commonly used treatment options for knee pain. After performing the task, participants were given a printed handout illustrating their preferences.


RESULTS
In total, 87 patients were randomized. Decisional self-efficacy, preparedness to participate in decision-making, and arthritis self-efficacy were greater in participants randomized to the intervention arm compared to those receiving the information pamphlet (p < 0.05 for all comparisons).


CONCLUSIONS
Participants using a tool designed to increase patient awareness of choice and evaluate the tradeoffs related to available treatment options were more confident in their ability to obtain information about available treatment options, were better prepared to participate in their visit, and had better arthritis related self-efficacy compared to patients receiving an information pamphlet. The results of this pilot study justify future large-scale trials to determine the effectiveness of similar interventions.
Fraenkel
Liana
L
Veterans Affairs Connecticut Healthcare System and the Yale University School of Medicine, New Haven, Connecticut, USA. liana.fraenkel@yale.edu
Rabidou
Nicole
N
Wittink
Dick
D
Fried
Terri
T
D000368:Aged; D000554:Ambulatory Care Facilities; D018771:Arthralgia / Q000628:therapy*; D003657:Decision Making; D003658:Decision Making, Computer-Assisted; D006787:Hospitals, Veterans; D006801:Humans; D007719:Knee Joint; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D010358:Patient Participation / Q000379:methods*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010865:Pilot Projects; D020377:Self Efficacy