REPORTS FROM THE FIELD
Video helps patients make decisions
Better education may reduce back surgery rates
Back surgery rates in the United States are rising rapidly, according to the Agency for Healthcare Quality and Research in Rockville, MD. A recent study in Medical Care finds that an interactive video helps patients make better decisions about whether or not to undergo elective back surgery.
Researchers randomly assigned 171 patients with a range of back problems including herniated disks and spinal stenosis into two groups. One group saw an interactive video and received an educational booklet about surgery for their condition; the second group received the booklet alone.
Symptom and function outcomes at three months and 12 months were similar for the two groups, but the overall surgery rate was 22% lower in the video group. Patients with herniated disks in the video group who learned that their problem usually improves with non-surgical care had a surgical rate of 32% compared to 47% for the booklet-only group. Patients with spinal stenosis in the video group who learned their condition would probably stay the same for years without surgery had higher surgery rates than the booklet-only group — 39% compared to 29%.
The video had little effect on patient satisfaction, but patients in the video group felt better informed than patients in the booklet-only group, researchers note.
[See: Deyo RA, Cherkin DC, Weinstein J, et al. Involving patients in clinical decisions: Impact of an interactive video program on use of back surgery. Medical Care 2000; 38:959-969.
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