Shared medical appointments as a new model for carpal tunnel surgery consultation: A randomized clinical trial

• Published in: Canadian journal of plastic surgery 2016-06, Vol.24 (2), p.107-112
• Main Authors: Wong, Alison L, Martin, Janet, Wong, Michael J, Bezuhly, Michael, Tang, David
• Format: Article
• Language: English
• Subjects: Carpal tunnel syndrome; Clinical trials; Informed consent; Original; Patient satisfaction; Physicians; Plastic surgery; Statistical analysis; Surgeons; Surgery
• ISSN: 2292-5503; 2292-5511
• DOI: 10.1177/229255031602400210

Background In chronic disease management, shared medical appointments have been shown to improve clinic access, productivity and patient education. However, adoption of this model in surgical consultation is limited, and its effect on surgical patients' satisfaction, comfort and surgical risk recall is unknown. Objective To determine whether shared medical appointments could be applied to carpal tunnel surgery consultation while being equally effective as individual consultation for risk recall, patient comfort and satisfaction. Methods A prospective randomized trial involving 80 patients referred for carpal tunnel release consultation, in which patients were assigned to an educational discussion individually or as part of a shared appointment, was conducted. In a blinded fashion, patients were contacted preoperatively to assess their risk recall and postoperatively to rate their overall satisfaction, comfort and satisfaction with the surgeon. Results Patient demographics were equal. Surgical risk recall was equivalent between shared and individual consults (2.06±1.15 versus 1.64±1.04; P=0.11). More participants in the shared appointments condition remembered the specific risks of infection (61.1% versus 33.3%; P=0.020) and bleeding (30.6% versus 10.3%; P=0.028). There was no difference in overall satisfaction (8.70 versus 8.88; P=0.75), satisfaction with the surgeon (8.05 versus 8.13; P=0.92) or overall comfort (8.80 versus 8.31; P=0.46). Discussion Shared medical appointments for carpal tunnel surgery consultation were equivalent to individual consultation in terms of surgical risk recall, patient satisfaction and comfort. Conclusion These results support the use of shared appointments for large-volume, low-variation surgery.