Said A. Ibrahim|Barbara H. Hanusa|Michael J. Hannon|Denise Kresevic|Judith A. Long|C. Kent Kwoh
Willingness and Access to Joint Replacement Among African American Patients With Knee Osteoarthritis: A Randomized, Controlled Intervention
Philadelphia VA Medical Center|University of Pennsylvania|VA Pittsburgh Healthcare System|VA Pittsburgh Healthcare System|University of Pittsburgh|Louis Stokes Cleveland VA Medical Center|Case Western Reserve University|University Hospitals Case Medical Center|Philadelphia VA Medical Center|University of Pennsylvania|VA Pittsburgh Healthcare System|University of Pittsburgh
african american patients significantly less likely undergo knee replacement management knee osteoarthritis oa racial difference preference willingness emerged key factor study undertaken examine efficacy patientcentered educational intervention patient willingness likelihood receiving referral orthopedic clinica total 639 african american patients moderatetosevere knee oa 3 veterans affairs primary care clinics enrolled randomized controlled trial 2 2 factorial design patients shown knee oa decisionaid video without brief counseling main outcome measures change patient willingness receipt referral orthopedic clinic also assessed whether patients discussed knee pain primary care provider saw orthopedic surgeon within 12 months interventionat baseline 67 participants definitelyprobably willing consider knee replacement difference among groups intervention increased patient willingness 75 groups 1 month received decision aid intervention alone gains sustained 3 months 12 months postintervention patients received intervention likely report engaging provider discussion knee pain 92 versus 85 receive referral orthopedic surgeon 18 versus 13 referral attend orthopedic consult 61 versus 50an educational intervention significantly increased willingness african american patients consider knee replacement also improved likelihood patientprovider discussion knee pain access surgical evaluation