A Research Agenda to Improve Patients' Experience of Knee Replacement Surgery: A Patient-Oriented Modified Delphi Study of Patients of South Asian Origin in British Columbia

For which topic were research priorities identified?

total knee arthroplasty

In which location was the research priority setting conducted?

North America - Canada

Why was it conducted at all?

As many as 20% of patients who have undergone total knee arthroplasty (TKA) are not satisfied with the outcome of their surgery. We need a better understanding of patient experiences and satisfaction with TKA, including differences between ethnic groups. Our team focused on understanding the experiences and satisfaction of patients of South Asian origin who had undergone TKA, as South Asians represent the largest visible minority group in Canada.

What was the objective?

to understand the experiences of patients of South Asian origin who undergo total knee arthroplasty and to identify a research agenda for this patient population

What was the outcome?

a ranking list of 25 research topics

How long did the research prioritization take?

Focus groups: July 2017 - August 2017. Delphi: March 2018 - April 2018

Which methods were used to identify research priorities?

Delphi; focus group

How were the priorities for research identified exactly?

Step 1: 3 focus groups with patients and caregivers: participants were asked to reflect on their entire TKA experience from diagnosis to longer term outcomes. Step 2: data processing: data analysis. Step 3: Delphi survey with health professionals. Delphi round 1: participants were asked to rate all potential research topics. Step 4: Delphi round 2: participants were asked to re-rate

Which stakeholders took part?

Eligible patients had to have had TKA surgery for osteoarthritis in Canada in the previous 2 years (to ensure we heard from patients and caregivers with recent surgical experience), be over 19 years of age, have South Asian ancestral roots and be able to converse in English or Punjabi or both languages. If an eligible patient was unwilling to participate, the patient’s caregiver was invited. Healthcare professionals included physiotherapists, orthopedic surgeons, primary care physicians, orthopedic nurses and occupational therapists who self-identified as providing care for patients of South Asian origin who undergo TKA. Focus group participants: 21 patients, 6 caregivers. Delphi: 31 patients, 5 caregivers, 27 doctors and nurses.

How were stakeholders recruited?

Patients and their caregivers were recruited through community outreach, health system contacts, word of mouth and a radio announcement made about the study on a popular South Asian radio station.

Were stakeholders actively involved or did they just participate?

Stakeholders were mere participants of the research prioritization process; they were not actively involved in the process.