African American Preference for Knee Replacement: A Patient-Centered Intervention (ACTION)
Knee Osteoarthritis
About this trial
This is an interventional health services research trial for Knee Osteoarthritis focused on measuring Knee Arthroplasty, Knee Osteoarthritis, Osteoarthritis, disparity, joint replacement
Eligibility Criteria
Inclusion Criteria:
- African-American patient referred to orthopedic doctor
- Age 50 or older
- Presence of knee OA by American College of Rheumatology as evidenced by:
- Chronic, frequent knee pain based on the NHANES questions.
- Moderate to severe knee OA based on WOMAC index score 39.
- Radiographic evidence of knee OA.
Exclusion Criteria:
- Prior history of any major joint replacement.
- Terminal Illness (e.g. end stage cancer).
- Physician diagnosed inflammatory arthritis (i.e., rheumatoid arthritis, connective tissue disease, ankylosing spondylitis, or other seronegative Spondyloarthropathy.)
- Contra-indications to replacement surgery (e.g., lower extremity paralysis as result of stroke).
- Prosthetic leg
- Cognitive impairment (e.g.,dementia)
- No home telephone service.
Sites / Locations
- University of Pennsylvania
Arms of the Study
Arm 1
Arm 2
No Intervention
Experimental
Attention control
Decision Aid (DA) Intervention
Subjects randomized to the attention control arm will receive an educational program (an NIH-developed booklet) that summarizes how to live with knee OA but does not specifically mention joint replacement. This booklet provides information about OA, examples of exercises one could do to improve pain and reduce stiffness, types of non-drug pain relief such as massage, and information about various medications. The interventionist will give the participant the booklet and describe what can be found inside. They are also encouraged to ask their doctor any questions they may have about the information in the booklet or questions they may have about their OA. The purpose of this educational program is to provide a tangible clinical incentive to the control group for participating in this additional component of the study.
Patients randomized to the DA Intervention will watch a Knee OA Decision Aid (DA) developed by the Foundation for Informed Medical Decision Making and then receive a brief counseling session called "AskMe3." The DA is a video that provides viewers with information about OA, treatment choices such as lifestyle changes, non-drug treatments, medication, injections, complementary therapies, and surgery, as well as the pros and cons of each type of treatment. The AskMe3 is a communication, skill-building intervention, which instructs patients to ask 3 questions to the doctor: 1) What is my main problem? 2) What do I need to do? 3) Why is it important for me to do this?