Sometimes, you just have to get back to the basics.
That is what researchers in Scotland have done with the new study, “The impact of a preoperative information leaflet on expectation management, satisfaction and patient outcomes in patients undergoing knee arthroscopy,” which appears in the August 18, 2019 edition of The Knee.
Co-author David Hamilton, Ph.D. with the Department of Orthopaedics and Trauma at the University of Edinburgh explained the objectives of this new study to OTW, “In the old days, leaflets were well used as an educational tool—really useful in that the clinical team provides the information they believe to be accurate and appropriate and applied this information within a local context.”
“This has gone out of fashion of late with a move to online information and apps. We felt that in time-pressured clinics it can be challenging to spend enough time with patients to really talk through surgical options and that the ‘simpler’ or routine procedures probably suffered the most in this context.”
“We felt that revisiting the use of a leaflet could be useful in knee arthroscopy in terms of improving the preoperative education process, setting expectations and possibly even in enhancing outcomes.”
So, Hamilton and his team undertook this project which was, essentially, a pilot, a simple, small study.
To test their hypothesis, Hamilton and his colleagues enrolled 55 patients who’d undergone knee arthroscopy over a nine-month period. Of the 55 enrolled, 28 received a leaflet preoperatively which provided more information about their upcoming procedure and 27 did not.
Dr. Hamilton described what they learned from the study: “The main finding, from our perspective, was that our patients reported an enhanced feeling of involvement in the process. We also saw a greater report of meeting preoperative expectations, though this was not at a statistically significant level in this small cohort, and there was no bleed through to pain or function outcome scores.”
“The feeling of greater inclusion we found contradicts the derisory suggestion that medical leaflets are ‘nothing more than proof that the surgeon consented the patient,’ and this simple handout may actually have a valuable role in clinical practice. Providing a leaflet at the time of preoperative consultation may be a cheap and effective way of helping patients feel more involved in the decision-making process.”
“I think that feelings of inclusion are very important at face value, but these are not necessarily what drives the typical patient outcome metrics that we like to report.”
“We wrote up a large series five years ago of 5,000 arthroplasty cases and showed the patient satisfaction metric was influenced by three factors—meeting of preoperative expectations, achieving satisfactory pain relief and the patient’s hospital experience—NOT the functional things we think are important.”
“I think the adjunct of the leaflet in enhancing the consent process is very relevant, but that this is only in the (important) context of achieving patient-centered care—it doesn’t affect outcome metrics because these measure different things.”
