Can an app improve patients' knowledge of their medical condition and treatment options?

INTERVENTION: A surgeon‐blinded randomized controlled trial was conducted with 213 patients who were referred to one of the six Dutch hospitals by their general practitioner owing to knee complaints that were indicative of knee osteoarthritis (OA). The eligibility of patients was assessed during their first contact with the hospital to schedule their appointment with the orthopedic surgeon. One group of patients were randomly allocated to use an interactive app that, in addition to standard care, actively sends informative and pertinent content to patients about their illness on a daily basis by means of push notifications in the week prior to their consultation with the orthopedic surgeon. Patients received, on a daily base and by means of push notifications, information about one of the following topics: the knee and the origin of the complaints, conservative treatment, surgical treatment, risks, rehabilitation after discharge and expectations. Each day covered one topic. Video, images and text were used as modes of information. Quiz‐like questions were asked after each video to provide direct feedback of patients' understanding of the information. Patients in the control group did not receive the app. They had access to all the standard information (eg. website, brochure) that is normally offered to them in the period prior to the consultation. After accepting participating in the study, patients were automatically online randomised. No blocks or clusters were used. CONDITION: Knee osteoarthritis ; Musculoskeletal Diseases PRIMARY OUTCOME: Patients' knowledge (perceived and actual) about their illness and the treatment options. Actual knowledge was measured 2 days prior to the consultation by a 12‐item multiple choice questionnaire, with possible scores ranging from 0 to 36. Perceived knowledge was also measured 2 days before the consultation by a 5‐item multiple choice questionnaire, with possible scores ranging from 0 to 25. SECONDARY OUTCOME: 1. Satisfaction with information and patient knowledge was measured 2 days before the consultation by using NRS scores ranging from 0 to 10; 2. Certainty of the treatment chosen was measured 1 day after the consultation using an NRS 0 to 10 scale. INCLUSION CRITERIA: 1. Referred by GP to orthopedic surgeon for suspected knee osteoarthritis 2. Fluent in Dutch 3. Possess an email address and a smart phone or tablet 4. At least 10 days between scheduling the appointment and the hospital visit were required, to give patients in the app group the chance to experience the intervention