Musculoskeletal Diseases Commons^™

Is There Room For Individual Patient-Specified Preferences In The Patient-Reported Outcome Measurement Revolution?, Leif I. Solberg, Jeanette Y. Ziegenfuss, Rachael L. Rivard, Christine K. Norton, Robin R. Whitebird, Glyn Elwyn, Mark Swiontkowski

Journal of Patient-Centered Research and Reviews

Purpose: The study aim was to test the feasibility of collecting qualitative patient-preferred outcomes or goals and the degree of their attainment as an addition to a standardized process for collecting quantitative composite patient-reported outcome measures (PROMs) from patients undergoing knee joint replacement..

Methods: Patients of a large Midwestern medical group scheduled to have total replacement of their knee joint have been asked to complete a PROMs survey preoperatively and at 3 and 12 months after surgery since 2014. In March 2020, an open-ended question about their most important preferred outcome was added to the existing questionnaire. The responses for …

Impact Of Perioperative Dexamethasone On Hospital Length Of Stay And Glycemic Control In Patients With Type 2 Diabetes Undergoing Total Hip Arthroplasty, Vanessa Williams, Mohammad J. Uddin Ansari, Amruta Jaju, Stacey Ward, Daniel O'Keefe, Jumana Abdelkarim, Nicole Montes, Ula Tarabichi, Albert Botchway, Michael G. Jakoby Iv

Journal of Patient-Centered Research and Reviews

Purpose: This study aimed to evaluate effects of perioperative dexamethasone on hospital length of stay (LOS) and glycemic control for patients with type 2 diabetes mellitus undergoing total hip arthroplasty (THA).

Methods: We performed retrospective case review of THA performed in adults (≥ 18 years old) with type 2 diabetes at Springfield Memorial Hospital (Springfield, IL) immediately before (2013), during (2014), and after (2015) publication of consensus guidelines for use of perioperative dexamethasone. Hospital LOS was the primary endpoint. Capillary blood glucose by hospital day, proportion of patients treated with insulin, and median insulin dose by hospital day …

Cost Analysis Of Implementing An Exercise Program For Fall And Fracture Prevention In Older Adults On Proton Pump Inhibitor Therapy, Thomas Adam Wichelmann, Nhan Dang, David H. Kruchko, Sufyan Abdulmujeeb, Eli D. Ehrenpreis

Journal of Patient-Centered Research and Reviews

Purpose: Falls have significant financial impact. Proton pump inhibitor (PPI) therapy is associated with an increased risk of falls and fractures. Exercise programs have been shown to decrease risk of falls in the elderly population and are recommended by the U.S. Preventive Services Task Force for patients over age 65 to reduce falls. Our study aimed to explore the potential financial benefit of implementing three different Centers for Disease Control and Prevention-recommended exercise-based interventions for fall prevention (Tai Chi, Stepping On, and Otago Exercise Program) in ≥ 65-year-old patients on PPI therapy.

Methods: A Markov model was developed to predict …

Patient Satisfaction With Care Is Associated With Better Outcomes In Function And Pain 1 Year After Lumbar Spine Surgery, Björn Knutsson, Bakir Kadum, Ted Eneqvist, Sebastian Mukka, Arkan S. Sayed-Noor

Journal of Patient-Centered Research and Reviews

Purpose: There has been increasing interest in patient-reported experience measures (PREMs) to evaluate the patient experience and satisfaction with care. We conducted a prospective multicenter cohort study to determine any association between patients’ satisfaction of care and their outcomes 1 year after lumbar spine surgery.

Methods: Satisfaction with care was recorded through telephone interviews and a standardized questionnaire. Baseline data collection (300 patients) and 1-year follow-up (209 patients) were conducted through The Swedish National Register for Spine Surgery (Swespine). Exposures were patient experiences, health care professional (HCP) attitudes, shared decision-making, and overall satisfaction with care. Associations were evaluated using adjusted …

The Experience Of Off Periods In Parkinson’S Disease: Descriptions, Triggers, And Alleviating Factors, Sneha Mantri, Madeline Lepore, Briana Edison, Margaret Daeschler, Catherine Kopil, Connie Marras, Lana Chahine

Journal of Patient-Centered Research and Reviews

Purpose: Wearing off of Parkinson’s disease medication is common, but triggers and coping strategies for this transient phenomenon are poorly understood. We aimed to assess the lived experience of OFF periods for people with Parkinson’s disease.

Methods: Participants in the longitudinal Fox Insight study who endorsed OFF periods were invited to complete a survey consisting of both multiple-choice and free-text responses. Descriptive statistics were used to summarize multiple-choice responses, and free-text responses were classified into themes through iterative discussion by 3 movement disorders specialists.

Results: A total of 2110 participants (52.4% male) completed the survey. Tremor was the most common …

Assessing The Patient-Perceived Monetary Value Of Patient-Reported Outcome Improvement For Patients With Chronic Knee Conditions, Sarah B. Floyd, Alicia Oostdyk, Melanie Cozad, John M. Brooks, Paul Siffri, Brian Burnikel

Journal of Patient-Centered Research and Reviews

Purpose: The high cost of orthopaedic care has attracted criticism in the current value-based health care environment. The objective of this work was to assess the properties of a willingness to pay (WTP)-based approach to estimate the monetary value that patients place on health improvements in chronic knee conditions following orthopaedic treatment.

Methods: A sample of patients with a chronic knee condition were surveyed between January and May of 2018 at a large orthopaedic practice. Each patient provided their WTP for restoration to ideal knee health and completed the Single Assessment Numerical Evaluation (SANE) to describe their baseline knee state. …

What Outcomes Matter To Patients After Joint Or Spine Surgery?, Robin R. Whitebird, Leif I. Solberg, Christine K. Norton, Jeanette Y. Ziegenfuss, Stephen E. Asche, Elizabeth S. Grossman

Journal of Patient-Centered Research and Reviews

Purpose: Patient-reported outcome measures (PROMs) are increasingly used in clinical care, but there have been few studies of what patients identify as the most important outcomes.

Methods: Semi-structured interviews were conducted with 65 patients undergoing hip or knee replacement, spinal discectomy/laminotomy, or a spinal fusion. Interviews focused on outcomes patients identified as important, perceived usefulness of standardized PROMs measures, and contextual situations important to their care. Data were analyzed using a directed content analysis approach.

Results: Patients identified desired outcomes that were unique and important to them. Their preferred outcomes focused in the areas of freedom from pain, getting back …

Effects Of Revision Surgery On Grade Of Adverse Local Tissue Reaction Following Recall Of A Modular Hip Implant, Joseph F. Davies, Danielle M. Greer, Susan Truchan

Journal of Patient-Centered Research and Reviews

Background: The Stryker Rejuvenate modular hip implant device allows for greater versatility in matching a patient’s anatomy than conventional implants. Device recalls and in vivo metal hypersensitivity after total hip arthroplasty (THA) are common. However, recall of the Rejuvenate implant represents one of the largest recall volumes to date, highlighting our uncertainty regarding causes of device metal fretting/corrosion and adverse local tissue reaction (ALTR). While devices with metal-on-metal bearings historically were culprits for release of metal debris, more recently developed modular-neck devices add opportunity for adjacent metal components to rub together. With the Rejuvenate device, corrosion or fretting likely occurs …

Factors In Patient Responsiveness To Directional Preference-Matched Treatment Of Neck Pain With Or Without Upper Extremity Radiation, Benjamin Holmes, Ruta Brazauskas, Laura D. Cassidy, Rachel A. Wiegand

Journal of Patient-Centered Research and Reviews

Purpose

Patient-related predictive factors in responsiveness to directional preference therapy for neck pain with or without upper extremity radiation (NP/R) have not been reported. A directional preference is any neck movement that, when performed repeatedly to end range, results in centralization and/or alleviation of NP/R. It was hypothesized that patient compliance with a prescribed, directional preference-matched home exercise program would improve positive responsiveness to NP/R treatment.

Methods

Patient-related factors thought to affect responsiveness to care were collected retrospectively from charts and de-identified for patients with NP/R who underwent chiropractic treatment at a multispecialty spine clinic from January 2014 through June …

Which Clinical Guidelines Should Be Implemented For Management Of Osteopenia In Primary Care? A Clin-Iq, Turia Hollingsworth

Journal of Patient-Centered Research and Reviews

Literature review was conducted to determine clinical guidelines for osteopenia management of immunocompetent patients in the primary care setting. It was concluded that pharmacological treatment should be offered to patients with osteopenia if they are considered high risk, which can be determined by utilizing the World Health Organization Fracture Risk Assessment Tool (FRAX^®) to evaluate 10-year risk. Patients with a calculated hip fracture probability of at least 3% or those with probability of 20% or more for all osteoporotic fractures may be offered bisphosphonate therapy.