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Research Highlights
VA Study Finds African-American Patients Less "Willing" To Consider Joint Replacement Therapy
Taken from the Veterans Health Administration Highlights dated December 6, 2002
A recent VA study found that white men are more likely than African American men to undergo knee and hip joint replacement for end-stage osteoarthritis.
The study, "Differences in Expectations of Outcome Mediate African American/White Patient Differences in ‘Willingness’ to Consider Joint Replacement," was published in the September 2002, issue of Arthritis & Rheumatism.
Author of the study, Dr. Said A. Ibrahim, VA Center for Health Equity Research and Promotion in Pittsburgh, said that one in every 115 Americans over the age of 65 years has had a joint replacement, which is a cost-effective treatment option for end-stage osteoarthritis of the knee and/or hip. Yet, there are marked racial/ethnic disparities in the use of this procedure.
Working with Laura A. Siminoff, PhD, Christopher J. Burant, MS, and C. Kent Kwoh, MD, the team found that "willingness" to consider joint replacement can best be viewed as a culmination of numerous clinical, social and personal factors (e.g., familiarity with the procedure and outcome expectations). Their study showed that African Americans were less likely than whites to be familiar with joint replacement and more likely to expect a longer hospital stay, pain and disability following replacement surgery. Consequently, African American patients were less "willing" than white patients to consider joint replacement.
Investigators of this study compared elderly male VA patients with moderate-to-severe symptomatic knee or hip osteoarthritis between May 1997 and March 2000. They examined the patient’s "willingness" to undergo surgery as well as patient-level demographic, psychosocial, and clinical factors that influence decisions. A total of 596 patients, all at the Louis Stokes VA Medical Center in Cleveland were eligible and included into the study.
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