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What are patients’ preferences for revision surgery after periprosthetic joint infection? A discrete choice experiment

OBJECTIVES: Understanding patients’ preferences for treatment is crucial to provision of good care and shared decisions, especially when more than one treatment option exists for a given condition. One such condition is infection of the area around the prosthesis after hip replacement, which affects...

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Autores principales: Carroll, Fran E, Gooberman-Hill, Rachael, Strange, Simon, Blom, Ashley W, Moore, Andrew J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044986/
https://www.ncbi.nlm.nih.gov/pubmed/31969360
http://dx.doi.org/10.1136/bmjopen-2019-031645
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author Carroll, Fran E
Gooberman-Hill, Rachael
Strange, Simon
Blom, Ashley W
Moore, Andrew J
author_facet Carroll, Fran E
Gooberman-Hill, Rachael
Strange, Simon
Blom, Ashley W
Moore, Andrew J
author_sort Carroll, Fran E
collection PubMed
description OBJECTIVES: Understanding patients’ preferences for treatment is crucial to provision of good care and shared decisions, especially when more than one treatment option exists for a given condition. One such condition is infection of the area around the prosthesis after hip replacement, which affects between 0.4% and 3% of patients. There is more than one treatment option for this major complication, and our study aimed to assess the value that patients place on aspects of revision surgery for periprosthetic hip infection. DESIGN: We identified four attributes of revision surgery for periprosthetic hip infection. Using a discrete choice experiment (DCE), we measured the value placed on each attribute by 57 people who had undergone either one-stage or two-stage revision surgery for infection. SETTING: The DCE was conducted with participants from nine National Health Service hospitals in the UK. PARTICIPANTS: Adults who had undergone revision surgery for periprosthetic hip infection (N=57). RESULTS: Overall, the strongest preference was for a surgical option that resulted in no restrictions on engaging in valued activities after a new hip is fitted (β=0.7). Less valued but still important attributes included a shorter time taken from the start of treatment to return to normal activities (6 months; β=0.3), few or no side effects from antibiotics (β=0.2), and having only one operation (β=0.2). CONCLUSIONS: The results highlight that people who have had revision surgery for periprosthetic hip infection most value aspects of care that affect their ability to engage in normal everyday activities. These were the most important characteristics in decisions about revision surgery.
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spelling pubmed-70449862020-03-09 What are patients’ preferences for revision surgery after periprosthetic joint infection? A discrete choice experiment Carroll, Fran E Gooberman-Hill, Rachael Strange, Simon Blom, Ashley W Moore, Andrew J BMJ Open Surgery OBJECTIVES: Understanding patients’ preferences for treatment is crucial to provision of good care and shared decisions, especially when more than one treatment option exists for a given condition. One such condition is infection of the area around the prosthesis after hip replacement, which affects between 0.4% and 3% of patients. There is more than one treatment option for this major complication, and our study aimed to assess the value that patients place on aspects of revision surgery for periprosthetic hip infection. DESIGN: We identified four attributes of revision surgery for periprosthetic hip infection. Using a discrete choice experiment (DCE), we measured the value placed on each attribute by 57 people who had undergone either one-stage or two-stage revision surgery for infection. SETTING: The DCE was conducted with participants from nine National Health Service hospitals in the UK. PARTICIPANTS: Adults who had undergone revision surgery for periprosthetic hip infection (N=57). RESULTS: Overall, the strongest preference was for a surgical option that resulted in no restrictions on engaging in valued activities after a new hip is fitted (β=0.7). Less valued but still important attributes included a shorter time taken from the start of treatment to return to normal activities (6 months; β=0.3), few or no side effects from antibiotics (β=0.2), and having only one operation (β=0.2). CONCLUSIONS: The results highlight that people who have had revision surgery for periprosthetic hip infection most value aspects of care that affect their ability to engage in normal everyday activities. These were the most important characteristics in decisions about revision surgery. BMJ Publishing Group 2020-01-21 /pmc/articles/PMC7044986/ /pubmed/31969360 http://dx.doi.org/10.1136/bmjopen-2019-031645 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Surgery
Carroll, Fran E
Gooberman-Hill, Rachael
Strange, Simon
Blom, Ashley W
Moore, Andrew J
What are patients’ preferences for revision surgery after periprosthetic joint infection? A discrete choice experiment
title What are patients’ preferences for revision surgery after periprosthetic joint infection? A discrete choice experiment
title_full What are patients’ preferences for revision surgery after periprosthetic joint infection? A discrete choice experiment
title_fullStr What are patients’ preferences for revision surgery after periprosthetic joint infection? A discrete choice experiment
title_full_unstemmed What are patients’ preferences for revision surgery after periprosthetic joint infection? A discrete choice experiment
title_short What are patients’ preferences for revision surgery after periprosthetic joint infection? A discrete choice experiment
title_sort what are patients’ preferences for revision surgery after periprosthetic joint infection? a discrete choice experiment
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044986/
https://www.ncbi.nlm.nih.gov/pubmed/31969360
http://dx.doi.org/10.1136/bmjopen-2019-031645
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