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AN EXPLORATION OF PATIENTS’ ATTITUDES TO A RANDOMISED CONTROLLED TRIAL OF ACCELERATED DISCHARGE FOLLOLWING ELECTIVE ORTHOPAEDIC SURGERY (OXFORD UNICOMPARTMENTAL KNEE ARTHROPLASTY)



Abstract

Purpose – Improve health professionals’ knowledge and understanding of patients’ perspectives of a randomised controlled trial of accelerated discharge following elective orthopaedic surgery.

Methods/Design – A qualitative study using purposive sampling and in-depth, semi-structured interviews was carried out with 16 patients who were approached about taking part in a randomised controlled trial comparing accelerated discharge within 24 hours with conventional management. Nine patients who consented and seven who declined the trial were interviewed; the interviews were tape recorded, transcribed and analysed thematically.

Main results – Patients who entered the trial did so because they were attracted by the possibility of early discharge and for altruistic reasons of helping medical research. Those who refused did so because they worried that they would not have the required domestic assistance at home.

Conclusions – Most people who took part in this trial expressed satisfaction. The accelerated discharge option was not seen to be disadvantageous. Those who refused did so for social rather than medical reasons. With the increase in early discharge schemes this social concern will have to be addressed if patients’ wishes are to be met. The large number of refusals (17 out of 58) may have implications in the planning of RCTs, in that sufficient time needs to be allocated for recruitment.

Correspondence should be addressed to Roger Smith, Honorary Secretary, BASK c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London WC2A 3PN