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NEW ORLEANS, LA -– A short, inexpensive educational
videotape significantly improved patients' satisfaction with
their doctor's visit and their compliance with subsequent
treatment, a new study from Duke University Medical Center has
shown. Pamphlets were found to be virtually worthless.

In the first such study comparing videos to written
materials utilizing a spectrum of patient measures – from basic
understanding of their condition to confidence in treatment to
following doctor's orders – the Duke researchers have
demonstrated the superiority of the moving image over the
written word.

Patient education tools are just one strategy in what
researcher Dr. Lloyd Hey calls "diverting the river" of the way
medicine is practiced in the outpatient setting. He believes
that using videotapes as patient education tools will become an
integral component of the re-engineered "waiting room" of the
future.

Hey, an orthopedic surgeon and director of Duke's Center for
Clinical Effectiveness, prepared the results of his study for
presentation Friday (March 20) at the annual meeting of the
American Academy of Orthopaedic Surgeons.

Hey also envisions the use of interactive computers, where
patients can update information about themselves, their level
of satisfaction with their treatment, and learn more about
their condition. Instead of patients passively reading outdated
magazines or fuming about long waits, Hey wants patients to use
that time to actively learn about their condition and provide
information, via computers, to their physicians.

"If patients have seen a video before seeing me, I can focus
on the next level of education," Hey explained. "We can discuss
how their back pain and treatments will impact their everyday
lives, their families, their jobs. All the time spent in the
clinic should be additive – the time watching a video, using
the computer, the physician's evaluation. It all works to bring
a higher level of understanding of their problem.

"The way we as physicians see patients in the clinic hasn't
changed much in 80 years," Hey said. "Usually, the patients are
early, the doctor is late. We need to rethink the whole process
and re-engineer it so that the patient is more important than
the doctor."

The videotape study involved 313 patients who came to the
Duke outpatient spine clinic with complaints of lower back
pain. Before seeing their physician, one-third of the patients
watched a 15-minute low-back pain videotape; one-third were
given a pamphlet about back pain to read; and the remaining
one-third weren't given anything.

Immediately after the appointment, patients completed
detailed two-page questionnaires. Three weeks after the
appointment, researchers called patients to see how well they
were taking their prescribed medication, participating in
physical therapy and exercising on a regular basis.

"The video was clearly superior in increasing patients'
overall satisfaction with their experience, as well as
complying with treatment," Hey said. "For a very small
investment in tapes and equipment, we can provide a great
service to our patients. We were quite surprised to find how
badly the pamphlets compared – no better than doing
nothing."

Specifically, 88.4 percent of patients who watched the
videotape reported the highest score on the questionnaire for
compliance with treatment, compared to 69.5 percent for those
who received pamphlets and 72 percent who received nothing. For
satisfaction, video patients reported the highest score, at 66
percent, compared to 31 percent for both pamphlets and no
educational tools.

The videotape, produced by the Arthritis Foundation, was
selected for the study by researchers after many tapes were
viewed by focus groups composed of patients who have suffered
from back pain.

"The key to this particular video is that it features many
different kinds of patients talking about their experiences,
their fears, and the benefits of therapy," Hey said. "People
watching it can easily identify with others who are having the
same problems. Pamphlets just can't do that as
effectively."