Cette \u00e9tude a \u00e9valu\u00e9 les effets d\u2019un programme de deuxi\u00e8me opinion chez les patients recommand\u00e9s pour l\u2019arthroplastie du genou<\/span>.<\/p>\nM\u00e9thodes<\/p>\n
Les plus grandes caisses d\u2019assurance maladie l\u00e9gales en Bavi\u00e8re ont offert aux patients qui avaient \u00e9t\u00e9 recommand\u00e9s de subir une arthroplastie du genou la possibilit\u00e9 de participer \u00e0 un programme de deuxi\u00e8me opinion, qui consistait en une pr\u00e9sentation en personne \u00e0 un chirurgien exp\u00e9riment\u00e9 du genou. Cette \u00e9tude de cohorte incluait des patients cons\u00e9cutifs de ce programme de deuxi\u00e8me opinion qui ont sign\u00e9 un consentement \u00e9clair\u00e9 du 07\/10\/2016 au 14\/02\/2020. Les donn\u00e9es ont \u00e9t\u00e9 recueillies avant et apr\u00e8s la deuxi\u00e8me visite d\u2019opinion.<\/p>\n
R\u00e9sultats<\/p>\n
Un total de 141 (66%) de 215 patients qui se sont pr\u00e9sent\u00e9s pour un deuxi\u00e8me avis ont particip\u00e9 \u00e0 l\u2019\u00e9tude d\u2019\u00e9valuation. Le m\u00e9decin de deuxi\u00e8me avis a recommand\u00e9 l\u2019arthroplastie du genou \u00e0 40% des patients, plus tard l\u2019arthroplastie du genou si les conditions se sont aggrav\u00e9es \u00e0 40%, et aucune arthroplastie du genou \u00e0 20%. Apr\u00e8s r\u00e9ception du deuxi\u00e8me avis, 28 de 56 (41%) patients ind\u00e9cis ont pr\u00e9f\u00e9r\u00e9 l\u2019arthroplasty de genou, 14 n\u2019ont eu aucun arthroplasty de genou, et 14 sont rest\u00e9s ind\u00e9cis. Quatre de 46 patients pr\u00e9sentant une pr\u00e9f\u00e9rence pour \u00ab arthroplasty \u00bb ont chang\u00e9 leur d\u00e9cision \u00e0 \u00ab aucune arthroplasty, \u00bb et cinq de 35 patients ont chang\u00e9 de \u00ab aucune arthroplasty \u00bb \u00e0 \u00ab arthroplasty. \u00bb Les patients \u00e9taient plus confiants dans leur d\u00e9cision selon l\u2019\u00e9chelle de confiance de d\u00e9cision<\/span> (avant : 5,4 \u00b1 3,0 ; apr\u00e8s : 7,8 \u00b1 2,5 ; p < 0,001). Ils ont \u00e9valu\u00e9 leur satisfaction \u00e0 l\u2019\u00e9gard du programme de deuxi\u00e8me opinion avec une note moyenne de 1,35 (\u00b1 0,60) (meilleur : 1 ; pire : 6). Les analyses de r\u00e9gression logistique ont montr\u00e9 que la recommandation du m\u00e9decin de deuxi\u00e8me opinion pour l\u2019arthroplastie articulaire a \u00e9t\u00e9 associ\u00e9e aux crit\u00e8res de ligne directrice s\u00e9v\u00e9rit\u00e9 radiologique de l\u2019ost\u00e9oarthrite (p = 0,001) et \u00e0 la qualit\u00e9 de vie genou-articulation-sp\u00e9cifique (p = 0,041).<\/p>\nConclusion<\/p>\n
La deuxi\u00e8me opinion d\u2019un chirurgien exp\u00e9riment\u00e9 de genou s\u2019\u00e9carte fr\u00e9quemment de la recommandation initiale pour l\u2019arthroplasty de genou. L\u2019association des crit\u00e8res de la ligne directrice \u00e0 la deuxi\u00e8me recommandation sugg\u00e8re une grande qualit\u00e9 de la deuxi\u00e8me opinion. Du point de vue du patient, la deuxi\u00e8me opinion r\u00e9duit les incertitudes dans sa d\u00e9cision de traitement.<\/p>\n","protected":false},"excerpt":{"rendered":"
R\u00e9sum\u00e9 Historique La l\u00e9gislation sociale allemande donne aux patients le droit d\u2019obtenir un deuxi\u00e8me avis avant la chirurgie \u00e9lective et d\u00e9finit des crit\u00e8res de qualit\u00e9 pour le remboursement par l\u2019assurance maladie l\u00e9gale. Cependant, les effets des deuxi\u00e8mes opinions avant la chirurgie \u00e9lective sont en grande partie inconnus. Cette \u00e9tude a \u00e9valu\u00e9 les effets d\u2019un programme […]<\/p>\n","protected":false},"author":8,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","hide_page_title":"","footnotes":""},"categories":[],"tags":[],"class_list":["post-14091","post","type-post","status-publish","format-standard","hentry"],"acf":[],"yoast_head":"\n
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Cependant, les effets des deuxi\u00e8mes opinions avant la chirurgie \u00e9lective sont en grande partie inconnus. 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MDVISIT CLINIC","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"fr_FR","og_type":"article","og_title":"Effets d\u2019un programme m\u00e9dical de deuxi\u00e8me opinion sur la d\u00e9cision des patients pour ou contre l\u2019arthroplastie du genou. - MDVISIT CLINIC","og_description":"R\u00e9sum\u00e9 Historique La l\u00e9gislation sociale allemande donne aux patients le droit d\u2019obtenir un deuxi\u00e8me avis avant la chirurgie \u00e9lective et d\u00e9finit des crit\u00e8res de qualit\u00e9 pour le remboursement par l\u2019assurance maladie l\u00e9gale. 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