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Revisiting patient satisfaction following total knee arthroplasty: a longitudinal observational study Bryan, Stirling; Goldsmith, Laurie J.; Davis, Jennifer Colleen; Hejazi, Samar; MacDonald, Valerie; McAllister, Patrick; Randall, Ellen; Suryaprakash, Nitya; Wu, Amery D.; Sawatzky, Richard

Abstract

Background: Total knee arthroplasty (TKA) is the most common joint replacement surgery in Canada. Earlier Canadian work reported 1 in 5 TKA patients expressing dissatisfaction following surgery. A better understanding of satisfaction could guide program improvement. We investigated patient satisfaction post-TKA in British Columbia (BC). Methods: A cohort of 515 adult TKA patients was recruited from across BC. Survey data were collected preoperatively and at 6 and 12 months, supplemented by administrative health data. The primary outcome measure was patient satisfaction with outcomes. Potential satisfaction drivers included demographics, patient-reported health, quality of life, social support, comorbidities, and insurance status. Multivariable growth modeling was used to predict satisfaction at 6 months and change in satisfaction (6 to 12 months). Results: We found dissatisfaction rates (“very dissatisfied”, “dissatisfied” or “neutral”) of 15% (6 months) and 16% (12 months). Across all health measures, improvements were seen post-surgery. The multivariable model suggests satisfaction at 6 months is predicted by: pre-operative pain, mental health and physical health (odds ratios (ORs) 2.65, 3.25 and 3.16), and change in pain level, baseline to 6 months (OR 2.31). Also, improvements in pain, mental health and physical health from 6 to 12 months predicted improvements in satisfaction (ORs 1.24, 1.30 and 1.55). Conclusions: TKA is an effective intervention for many patients and most report high levels of satisfaction. However, if the TKA does not deliver improvements in pain and physical health, we see a less satisfied patient. In addition, dissatisfied TKA patients typically see limited improvements in mental health.

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Title
Revisiting patient satisfaction following total knee arthroplasty: a longitudinal observational study
Creator
Bryan, Stirling; Goldsmith, Laurie J.; Davis, Jennifer Colleen; Hejazi, Samar; MacDonald, Valerie; McAllister, Patrick; Randall, Ellen; Suryaprakash, Nitya; Wu, Amery D.; Sawatzky, Richard
Contributor
Vancouver Coastal Health Authority. Centre for Clinical Epidemiology and Evaluation; Centre for Health Evaluation & Outcome Sciences; St. Paul's Hospital (Vancouver, B.C.)
Publisher
BioMed Central
Date Issued
2018-11-30
Description
Background: Total knee arthroplasty (TKA) is the most common joint replacement surgery in Canada. Earlier Canadian work reported 1 in 5 TKA patients expressing dissatisfaction following surgery. A better understanding of satisfaction could guide program improvement. We investigated patient satisfaction post-TKA in British Columbia (BC). Methods: A cohort of 515 adult TKA patients was recruited from across BC. Survey data were collected preoperatively and at 6 and 12 months, supplemented by administrative health data. The primary outcome measure was patient satisfaction with outcomes. Potential satisfaction drivers included demographics, patient-reported health, quality of life, social support, comorbidities, and insurance status. Multivariable growth modeling was used to predict satisfaction at 6 months and change in satisfaction (6 to 12 months). Results: We found dissatisfaction rates (“very dissatisfied”, “dissatisfied” or “neutral”) of 15% (6 months) and 16% (12 months). Across all health measures, improvements were seen post-surgery. The multivariable model suggests satisfaction at 6 months is predicted by: pre-operative pain, mental health and physical health (odds ratios (ORs) 2.65, 3.25 and 3.16), and change in pain level, baseline to 6 months (OR 2.31). Also, improvements in pain, mental health and physical health from 6 to 12 months predicted improvements in satisfaction (ORs 1.24, 1.30 and 1.55). Conclusions: TKA is an effective intervention for many patients and most report high levels of satisfaction. However, if the TKA does not deliver improvements in pain and physical health, we see a less satisfied patient. In addition, dissatisfied TKA patients typically see limited improvements in mental health.
Subject
Total knee arthroplasty; Patient satisfaction; Longitudinal observational study; Survey research
Genre
Article
Type
Text
Language
eng
Date Available
2018-12-03
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0374941
URI
http://hdl.handle.net/2429/67962
Affiliation
Education, Faculty of; Management, Faculty of (Okanagan); Medicine, Faculty of; Other UBC; Non UBC; Educational and Counselling Psychology, and Special Education (ECPS), Department of; Population and Public Health (SPPH), School of
Citation
BMC Musculoskeletal Disorders. 2018 Nov 30;19(1):423
Publisher DOI
10.1186/s12891-018-2340-z
Peer Review Status
Reviewed
Scholarly Level
Faculty
Copyright Holder
The Author(s).
Rights URI
http://creativecommons.org/licenses/by/4.0/
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Attribution 4.0 International (CC BY 4.0)