title: Shared medical appointments as a new model for carpal tunnel surgery consultation: A randomized clinical trial.
abstract: BACKGROUND
  In chronic disease management, shared medical appointments have been shown to improve clinic access, productivity and patient education. However, adoption of this model in surgical consultation is limited, and its effect on surgical patients' satisfaction, comfort and surgical risk recall is unknown.
  
  
  OBJECTIVE
  To determine whether shared medical appointments could be applied to carpal tunnel surgery consultation while being equally effective as individual consultation for risk recall, patient comfort and satisfaction.
  
  
  METHODS
  A prospective randomized trial involving 80 patients referred for carpal tunnel release consultation, in which patients were assigned to an educational discussion individually or as part of a shared appointment, was conducted. In a blinded fashion, patients were contacted preoperatively to assess their risk recall and postoperatively to rate their overall satisfaction, comfort and satisfaction with the surgeon.
  
  
  RESULTS
  Patient demographics were equal. Surgical risk recall was equivalent between shared and individual consults (2.06±1.15 versus 1.64±1.04; P=0.11). More participants in the shared appointments condition remembered the specific risks of infection (61.1% versus 33.3%; P=0.020) and bleeding (30.6% versus 10.3%; P=0.028). There was no difference in overall satisfaction (8.70 versus 8.88; P=0.75), satisfaction with the surgeon (8.05 versus 8.13; P=0.92) or overall comfort (8.80 versus 8.31; P=0.46).
  
  
  CONCLUSIONS
  Shared medical appointments for carpal tunnel surgery consultation were equivalent to individual consultation in terms of surgical risk recall, patient satisfaction and comfort.
  
  
  CONCLUSIONS
  These results support the use of shared appointments for large-volume, low-variation surgery.
authors.affiliation: Division of Plastic & Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia.
authors.forename: Alison L
authors.initials: AL
authors.lastname: Wong
authors.affiliation: Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia.
authors.forename: Janet
authors.initials: J
authors.lastname: Martin
authors.affiliation: Department of Anesthesia, Dalhousie University, Halifax, Nova Scotia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Wong
authors.affiliation: Division of Plastic & Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia.
authors.forename: Michael
authors.initials: M
authors.lastname: Bezuhly
authors.affiliation: Division of Plastic & Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia.
authors.forename: David
authors.initials: D
authors.lastname: Tang
keywords: Carpal tunnel; Health care delivery; Health management; Patient education; Risk recall; Shared medical appointment