THU0430 PREPARING AN ORTHOPAEDIC CONSULTATION USING AN EHEALTH TOOL: A RANDOMIZED CONTROLLED TRIAL IN PATIENTS WITH HIP AND KNEE OSTEOARTHRITIS
Authors: Aniek Claassen, Henk J Schers, Vincent Jjf Busch, Petra Heesterbeek, Frank van den Hoogen, Thea Vliet Vlieland, Cornelia van den Ende
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Hip and knee OA patients who are referred to an orthopaedic surgeon often expect action to be taken.<sup>1</sup> However, the majority who of those patients is not (yet) eligible for a joint replacement.<sup>2,3</sup> We hypothesized that a solid preparation using the eHealth tool is likely to streamline patients' expectations and increase satisfaction, irrespective of the outcome of the consultation. <h3>Objectives</h3> To evaluate the effect of a stand-alone mobile and web-based educational intervention (eHealth tool) compared to usual preparation of a first orthopaedic consultation of patients with hip or knee osteoarthritis (OA) on patients' satisfaction. <h3>Methods</h3> A two-armed unblinded randomized controlled trial involving 286 patients with (suspicion of) hip or knee OA, randomly allocated to either receiving an educational eHealth tool to prepare their upcoming consultation (n=144) or usual care (n=142). Satisfaction with the consultation on three subscales (range 1-4) of the Consumer Quality Index (CQI - primary outcome) and knowledge (assessed using 22 statements on OA, range 0-22), treatment beliefs (assessed by the Treatment beliefs in OsteoArthritis questionnaire, range 1-5), pain medication use (yes/no), assessment of patient's involvement in consultation by the surgeon (assessed on a 5-point Likert scale) and patient satisfaction with the outcome of the consultation (numeric rating scale), were assessed. <h3>Results</h3> No differences between groups were observed on the 3 subscales of the CQI (group difference (95% CI): communication 0.009 (-0.10, 0.12), conduct -0.02 (-0.12, 0.07) and information provision 0.02 (-0.18, 0.21)). Between group differences (95% CI) were in favour of the intervention group for knowledge (1.4 (0.6, 2.2)), negative beliefs regarding physical activities (-0.19 (-0.37, -0.002) and pain medication (-0.30 (-0.49, -0.01)). We found no differences on other secondary outcomes. <h3>Conclusion</h3> An educational eHealth tool to prepare a first orthopaedic consultation for hip or knee OA does not result in higher patient satisfaction with the consultation, but it does influence cognitions about osteoarthritis. <h3>References</h3> [1] Samsson KS, Bernhardsson S, Larsson ME. "Take me seriously and do something!" - a qualitative study exploring patients' perceptions and expectations of an upcoming orthopaedic consultation. BMC Musculoskelet Disord 2017 Aug 24;18(1):367 [2] Barten DJ, Smink A, Swinkels IC, Veenhof C, Schers HJ, Vliet Vlieland TP, et al. Factors Associated With Referral to Secondary Care in Patients With Osteoarthritis of the Hip or Knee After Implementation of a Stepped-Care Strategy. Arthritis Care Res (Hoboken) 2017 Feb;69(2):216-25 [3] McHugh GA, Campbell M, Luker KA. GP referral of patients with osteoarthritis for consideration of total joint replacement: a longitudinal study. Br J Gen Pract 2011 Aug;61(589):e459-e468 <h3>Disclosure of Interests</h3> None declared