Effective communication and information retention in orthodontic patients : a randomised controlled trial

Abstract

Introduction: Effective communication is crucial for clinical governance, informed consent, risk management and person-centered care. Treatment outcomes are positively influenced when patients are knowledgeable and take part in shared decision-making. Retention of information is a major challenge in healthcare. The basis of this study is to identify a communication tool that orthodontists could utilise to deliver information in an effective, evidence-based manner to enhance patient compliance, motivation and adherence to instructions. A secondary aim is to identify whether having family members or friends who wore braces influences the knowledge score. Methods: Subjects were recruited from Mater Dei Hospital, Malta. Patients were between 10 and 18 years of age and required fixed appliance treatment. They were randomly allocated into an intervention and control group, 22 patients per group. Each group was given the same verbal and written instructions after the brace was fitted; the intervention group was also shown an audiovisual presentation. All sources of information conveyed the same instructions but in different formats. A questionnaire was used to measure participant knowledge at the first visit (T0) and 6 weeks later (T1). The independent and paired samples t-tests were used to compare the groups. Results: 40 patients completed the study with 4 dropouts. The mean knowledge score of the intervention group was 7.5% more than that of the control group at T0 (p=<.001). There was no statistical difference between the mean scores of the intervention and control group at T1. The intervention group experienced a notable reduction in recall of information in the long-term (p = .13); the mean knowledge score decreased by 6.2%. In the control group, there was no difference in retention of information in the long-term. A higher preliminary finding was associated with a larger reduction in score at follow-up. Having family or friends who wore braces did not significantly affect the mean scores at T0 and T1. Conclusions: Showing patients an audiovisual presentation in addition to verbal and written instructions is effective at improving understanding and retention of information in the short-term. The results suggest that instructions should be repeated at follow-up appointments and a strategy is needed to consolidate the short-term memory of orthodontic patients.