Abstract
The aim of this study was to investigate the association between patients’ experiences with trapeziometacarpal arthroplasty and treatment outcomes in terms of patient-reported outcome measures, grip and pinch strength. We included 233 patients who received a Weilby procedure for trapeziometacarpal osteoarthritis. Before surgery and 12 months after surgery, patients completed the Michigan Hand Outcomes Questionnaire, and their pinch and grip strengths were measured. At 3 months after surgery, a patient-reported experience measure was completed. Using regression analysis, significantly positive associations were found between the Michigan Hand questionnaire and the patient-reported experience measure, with the strongest significant associations being for patients’ experiences with information provision. No significant associations were found between the patients’ experience and strength outcomes. The results highlight the potential importance of positive experience with the treatment process to improve treatment outcomes in patients undergoing surgery for trapeziometacarpal osteoarthritis.Level of evidence: IV
Highlights
The context in which healthcare is delivered is an important part of a treatment, since the experience with healthcare delivery can contribute to treatment outcomes (Curran, 2007)
Another study showed that general practitioners (GPs) who received training in communication and pain assessment before treatment for osteoarthritis had significantly better outcomes, that is, their patients experienced significantly less pain compared with patients whose GPs did not receive this training (Chassany et al, 2006)
Linear regression analysis was used to examine the univariable relationship between PREMS and the change in outcomes after surgery (PROMS and strength outcomes), which were reported as beta coefficients
Summary
The context in which healthcare is delivered is an important part of a treatment, since the experience with healthcare delivery can contribute to treatment outcomes (Curran, 2007). The treatment context can be broadly defined as all aspects of the therapeutic context (e.g. treatment rationale, response to treatment) or the healthcare environment (e.g. quality of facilities, hygiene) that may affect patient perceptions across the continuum of care (Arnold et al, 2014; Connor-Greene, 1993; Wolf et al, 2014) When these aspects have an effect on treatment outcomes that cannot be attributed to the treatment itself, they are called ‘contextual effects’ (Miller and Kaptchuk, 2008; Moerman and Jonas, 2002). In many conditions, influencing the treatment context, for example by improving the communication between patient and clinician, can improve patient-reported health status (Di Blasi et al, 2001) To measure these contextual aspects of a treatment, questionnaires are available that can reliably quantify the patient’s experience with the delivered healthcare: such questionnaires are called patient-. In hand surgery, the empathy of the physician was the strongest driver of patient satisfaction, with 66% of the variation in patients’ satisfaction explained by the empathy of the physician (Menendez et al, 2015)
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