Introductory insights into patient preferences for outpatient rehabilitation after knee replacement: implications for practice and future research

Abstract

Objectives Current perspectives concerning clinical decision making favour inclusion ofpatient preference for therapy. This exploratory study aimed to forge introductory insightsinto patient preference for outpatient-based rehabilitation after total knee replacement(TKR).Methods TKR recipients from six public hospitals participating in a prospective, longitu-dinal study assessing outcomes after surgery were surveyed 1 year after surgery aboutpreferences for rehabilitation. Surveys were conducted face-to-face or via postal question-naire. Questions included global satisfaction (percentage scale) with therapy received,future preference for therapy and the reasons underpinning preference.Results Ninety-three (93/115) TKR recipients participated [mean age 68 (SD 8) years;66% female; 75% face-to-face interview]. Group-based (39/93) and one-to-one therapies(38/93) were the most common modes experienced. Most participants (81/93) were highlysatisfied (satisfaction ⱖ 75%). Future preference was associated with satisfaction with pastexposure regardless of mode (P = 0.02), hence no overall preference for one modeemerged. Commonality existed in the reasons why patients preferred specific modes. Themost common reason for preferring group-based therapy was psychosocial benefit whilstthe more personalized approach was the most common reason for preferring one-to-onetherapy.Conclusions Patient global satisfaction is similarly high across different modes of outpa-tient rehabilitation despite differences in perceived benefits. The association betweensatisfaction and preference potentially indicates that provided the service is deemed highquality, the actual mode of therapy offered is less important to this patient population.Research is required, however, to establish the relationship between preference andoutcome, the stability of preference across time, and the effect of multiple rehabilitationexposures on preference. For now, the quality of current uni-modal programmes could beenhanced by incorporation of features typically associated with alternative modes.