Does patient satisfaction after foot surgery change with time? A mid-term retrospective study using PASCOM-10

Abstract Background: Recording patient reported outcome measurements at six months after surgery using PASCOM-10 is common practice in podiatric surgery. The aim of this study is to establish if patient satisfaction after foot surgery is changed at the 12 month point.Method: An audit of patient reported outcomes following foot surgery was undertaken. Electronic case notes were examined, and 236 patients were identified over a 1-year period. Patients completed the Manchester Oxford Foot Questionnaire (MOXFQ) pre-surgery, at six-months post-operatively (in person/telephone conversation) and were then invited by letter to re-complete this again at 12-months post-operatively. 91 participants (39%) completed both post-operative questionnaires (66 females 25 males). The average age was 64 (range: 35-93). Results: The results demonstrate that there was a significant effect between the three time points in the MOXFQ domains of walking/standing, pain and social interaction (0.353, F (6, 356) = 40.59, p <.001), and a further interaction with gender (0.435, F (6,352) = 30.23, p <.001). An average, positive change in patient satisfaction in all domains is the greatest from pre-surgery to 6-months post-surgery at 78% and then decreases to 62% 12-months post-surgery. Negative and insignificant changes are highest from 6 to 12 months. Females experience lower satisfaction at the six- and 12-month post-operative time points but gain the greatest improvement in patient satisfaction at 30%. National PASCOM data significant with all domain comparisons data (p< .001) is a subset. Conclusion: A patient centred approach is key in foot surgery when determining patient satisfaction. Patient satisfaction levels change significantly at different time points. In this review, the overall patient satisfaction improved with surgery, but with a higher response score at six months than 12. A short period of recovery may not yield the genuine long-term patient reported outcomes and increase to 12 months is recommended from the more common six months. However, the differencing methods of collecting post-operative data may have had an influence on scores.