The impact of a patient decision aid on intention to undergo surgery for subacromial pain syndrome: An online randomised controlled trial |
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| Affiliation: | 1. Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia;2. Institute for Musculoskeletal Health, Royal Prince Alfred Hospital, Sydney Local Health District, Level 10 North, King George V Building, P.O. Box M179, Missenden Road, Camperdown, Sydney, NSW, Australia;3. Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia;4. Whitlam Orthopaedic Research Center, Orthopaedic Department, Liverpool Hospital, Sydney, NSW, Australia;1. Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil;2. Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, The University of Minnesota, Minneapolis, MN, USA;3. Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA;4. Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA;1. Rehabilitation Science Postgraduation Program, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil;2. Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia;3. Physical Therapy Department, Instituto Federal do Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil;1. Ghent University, Faculty of Medicine and Health Sciences, University Hospital Ghent, Department of Rehabilitation Sciences (Physical Therapy), Gent, Belgium;2. University of Copenhagen, Department of Occupational and Physical Therapy and Institute of Sports Medicine, Bispebjerg Hospital, Bispebjerg Bakke 23, Copenhagen, Denmark |
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| Abstract: | ObjectiveTo evaluate the effects of a patient decision aid for people considering shoulder surgery.MethodsParticipants with shoulder pain considering shoulder surgery (n = 425) were recruited online and randomised to (i) a decision aid outlining the benefits and harms of shoulder surgery and non-surgical options (then randomised to a side-by-side vs. top-and-bottom display of options); and (ii) general information about shoulder pain from the NHS. Outcomes included treatment intention (primary), knowledge, attitudes, informed choice, and decisional conflict. Linear and logistic regression models were used to evaluate between-groups differences in outcomes.Results409 participants (96%) had post-intervention data. Mean age was 41.3 years, 44.2% were female. There was no between-group difference in post-intervention treatment intention (MD ?0.2, 95% CI: ?3.3 to 2.8) and likelihood of intending to have shoulder surgery (OR 0.7, 95% CI: 0.3–1.5). The decision aid slightly improved knowledge (MD 4.4, 95% CI: 0.2–8.6), but not any other secondary outcomes. The display of options did not influence any outcome.ConclusionsIn this online trial, a co-designed patient decision aid had no effect on treatment intention, attitudes, informed choice, and decisional conflict, but a small effect on improving knowledge.Practice implicationsResearch is needed to understand reasons for the lack of anticipated effects.Trial registrationAustralia New Zealand Clinical Trials Registry (ACTRN12621000992808). |
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| Keywords: | Shoulder surgery Subacromial decompression Rotator cuff repair Decision aid Shared decision making |
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