Journal CME, March 2022: Treatment Decisions after Interdisciplinary Evaluation for Nonarthritic Hip Pain: A Randomized Controlled Trial-Treatment Decisions after Interdisciplinary Evaluation

Treatment Decisions after Interdisciplinary Evaluation - Article.pdf

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This study evaluates the impact of interdisciplinary evaluation involving both a physical therapist and an orthopedic surgeon on treatment decisions and decisional conflict for patients with nonarthritic hip pain (NAHP). Conducted as a randomized controlled trial, participants were assigned to either a standard evaluation group (orthopedic surgeon only) or an interdisciplinary evaluation group (orthopedic surgeon and physical therapist). The study aimed to determine whether interdisciplinary evaluation influences the inclusion of physical therapy in treatment plans and reduces decisional conflict.<br /><br />Participants in the interdisciplinary group received a comprehensive evaluation involving a physical therapist assessment of functional movements in addition to the standard surgical evaluation. Both groups then received their respective treatment plans, and their decisional conflict was assessed using the Decisional Conflict Scale (DCS).<br /><br />Key findings include:<br />1. **Physical Therapy Inclusion**: 66% of participants in the interdisciplinary group included physical therapy in their post-evaluation treatment plans compared to 48% in the standard group. However, this difference was not statistically significant (p = .10).<br />2. **Decisional Conflict**: The interdisciplinary group reported significantly lower decisional conflict regarding their treatment plans (mean DCS: 10.2) compared to the standard group (mean DCS: 16.5, p = .04). Both groups showed significant reductions in decisional conflict from pre- to post-evaluation.<br /><br />Secondary analyses revealed that many participants altered their interest in physical therapy post-evaluation, with the interdisciplinary evaluation particularly influencing those initially uninterested in physical therapy. However, both evaluation types resulted in considerable reductions in decisional conflict overall.<br /><br />Despite the non-significant increase in physical therapy inclusion, the interdisciplinary group displayed notably reduced decisional conflict, indicating the potential benefit of incorporating a physical therapist into the preoperative evaluation process. Future studies should continue exploring interdisciplinary care models to enhance decision-making and patient outcomes in individuals with NAHP.

Keywords

interdisciplinary evaluation

physical therapist

orthopedic surgeon

nonarthritic hip pain

randomized controlled trial

treatment decisions

decisional conflict

Decisional Conflict Scale

physical therapy inclusion

patient outcomes