Which disease-related factors influence patients’ and physicians’ willingness to consider joint replacement in hip and knee OA? Results of a questionnaire survey linked to claims data
Abstract Background A great heterogeneity in total joint replacement (TJR) rates has been reported for osteoarthritis (OA), most likely arising from a gap between patients’ and physicians’ views on the need for TJR. The purpose of this study therefore was to analyze potential cofactors which might i...
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doaj-dc1ba0ff4b4a4b228612c04a89894dce2020-11-25T03:12:04ZengBMCBMC Musculoskeletal Disorders1471-24742020-06-0121111110.1186/s12891-020-03368-1Which disease-related factors influence patients’ and physicians’ willingness to consider joint replacement in hip and knee OA? Results of a questionnaire survey linked to claims dataAnne Postler0Jens Goronzy1Klaus-Peter Günther2Toni Lange3Imke Redeker4Jochen Schmitt5Angela Zink6Johanna Callhoff7University Center of Orthopaedics and Traumatology, University Medicine Carl, Gustav Carus Dresden, TU DresdenUniversity Center of Orthopaedics and Traumatology, University Medicine Carl, Gustav Carus Dresden, TU DresdenUniversity Center of Orthopaedics and Traumatology, University Medicine Carl, Gustav Carus Dresden, TU DresdenCenter for Evidence-Based Healthcare, Medical Faculty, Technical UniversityDepartment of Gastroenterology, Infectiology and Rheumatology, Charité – Universitätsmedizin BerlinCenter for Evidence-Based Healthcare, Medical Faculty, Technical UniversityEpidemiology Unit, German Rheumatism Research CentreEpidemiology Unit, German Rheumatism Research CentreAbstract Background A great heterogeneity in total joint replacement (TJR) rates has been reported for osteoarthritis (OA), most likely arising from a gap between patients’ and physicians’ views on the need for TJR. The purpose of this study therefore was to analyze potential cofactors which might influence the desire of patients to undergo TJR and physicians’ willingness to discuss surgery with their patients. Methods A total of 8995 patients in Germany with a claims data diagnosis of hip or knee OA or polyarthrosis were asked to complete a questionnaire for this cross-sectional study of sociodemographic factors, indicators of current joint function (WOMAC score), willingness to undergo TJR and whether they had already discussed TJR with a physician. The overall response rate was 40%. Responders with polyarthrosis and individuals without current or chronic symptoms in the corresponding joints, pain in already replaced joints or simultaneous symptomatic hip and knee OA were excluded. We linked the survey results to claims data. Separate logistic regression models were used to assess which parameters were associated with patients’ willingness to undergo TJR and physicians’ discussion of surgery. Results We analyzed 478 hip OA and 932 knee OA patients. Just 17% with hip OA and 14% with knee OA were willing to undergo TJR, although 44 and 45% had already discussed surgery with their physicians. Patients’ willingness was associated with higher WOMAC scores, a deterioration of symptoms over the last 2 years, and previous TJR for another joint. The discussion with a physician was influenced by the impact on personal life and previous arthroplasty. Older age (odds Ratio (OR) 1.2 per 10 years), male sex (OR 0.69 vs female), longer symptom duration (OR 1.08 per 5 years), deterioration of symptoms (OR 2.0 vs no change/improvement), a higher WOMAC score (OR 1.3 per 10% deterioration) and reduced well-being (OR 1.1 per 10% deterioration) were associated with physician discussion in knee OA patients. Conclusions The proportion of patients willing to undergo TJR is lower than the proportion in whom physicians discuss surgery. While previous TJR seems to enhance patients’ and surgeons’ willingness, the influence of other cofactors is heterogeneous.http://link.springer.com/article/10.1186/s12891-020-03368-1Hip or knee osteoarthritisConservative treatment in osteoarthritisTotal joint replacementHealth service needs and demandsPatient preferencesNational guideline |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anne Postler Jens Goronzy Klaus-Peter Günther Toni Lange Imke Redeker Jochen Schmitt Angela Zink Johanna Callhoff |
spellingShingle |
Anne Postler Jens Goronzy Klaus-Peter Günther Toni Lange Imke Redeker Jochen Schmitt Angela Zink Johanna Callhoff Which disease-related factors influence patients’ and physicians’ willingness to consider joint replacement in hip and knee OA? Results of a questionnaire survey linked to claims data BMC Musculoskeletal Disorders Hip or knee osteoarthritis Conservative treatment in osteoarthritis Total joint replacement Health service needs and demands Patient preferences National guideline |
author_facet |
Anne Postler Jens Goronzy Klaus-Peter Günther Toni Lange Imke Redeker Jochen Schmitt Angela Zink Johanna Callhoff |
author_sort |
Anne Postler |
title |
Which disease-related factors influence patients’ and physicians’ willingness to consider joint replacement in hip and knee OA? Results of a questionnaire survey linked to claims data |
title_short |
Which disease-related factors influence patients’ and physicians’ willingness to consider joint replacement in hip and knee OA? Results of a questionnaire survey linked to claims data |
title_full |
Which disease-related factors influence patients’ and physicians’ willingness to consider joint replacement in hip and knee OA? Results of a questionnaire survey linked to claims data |
title_fullStr |
Which disease-related factors influence patients’ and physicians’ willingness to consider joint replacement in hip and knee OA? Results of a questionnaire survey linked to claims data |
title_full_unstemmed |
Which disease-related factors influence patients’ and physicians’ willingness to consider joint replacement in hip and knee OA? Results of a questionnaire survey linked to claims data |
title_sort |
which disease-related factors influence patients’ and physicians’ willingness to consider joint replacement in hip and knee oa? results of a questionnaire survey linked to claims data |
publisher |
BMC |
series |
BMC Musculoskeletal Disorders |
issn |
1471-2474 |
publishDate |
2020-06-01 |
description |
Abstract Background A great heterogeneity in total joint replacement (TJR) rates has been reported for osteoarthritis (OA), most likely arising from a gap between patients’ and physicians’ views on the need for TJR. The purpose of this study therefore was to analyze potential cofactors which might influence the desire of patients to undergo TJR and physicians’ willingness to discuss surgery with their patients. Methods A total of 8995 patients in Germany with a claims data diagnosis of hip or knee OA or polyarthrosis were asked to complete a questionnaire for this cross-sectional study of sociodemographic factors, indicators of current joint function (WOMAC score), willingness to undergo TJR and whether they had already discussed TJR with a physician. The overall response rate was 40%. Responders with polyarthrosis and individuals without current or chronic symptoms in the corresponding joints, pain in already replaced joints or simultaneous symptomatic hip and knee OA were excluded. We linked the survey results to claims data. Separate logistic regression models were used to assess which parameters were associated with patients’ willingness to undergo TJR and physicians’ discussion of surgery. Results We analyzed 478 hip OA and 932 knee OA patients. Just 17% with hip OA and 14% with knee OA were willing to undergo TJR, although 44 and 45% had already discussed surgery with their physicians. Patients’ willingness was associated with higher WOMAC scores, a deterioration of symptoms over the last 2 years, and previous TJR for another joint. The discussion with a physician was influenced by the impact on personal life and previous arthroplasty. Older age (odds Ratio (OR) 1.2 per 10 years), male sex (OR 0.69 vs female), longer symptom duration (OR 1.08 per 5 years), deterioration of symptoms (OR 2.0 vs no change/improvement), a higher WOMAC score (OR 1.3 per 10% deterioration) and reduced well-being (OR 1.1 per 10% deterioration) were associated with physician discussion in knee OA patients. Conclusions The proportion of patients willing to undergo TJR is lower than the proportion in whom physicians discuss surgery. While previous TJR seems to enhance patients’ and surgeons’ willingness, the influence of other cofactors is heterogeneous. |
topic |
Hip or knee osteoarthritis Conservative treatment in osteoarthritis Total joint replacement Health service needs and demands Patient preferences National guideline |
url |
http://link.springer.com/article/10.1186/s12891-020-03368-1 |
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