Health-GIS Platform for Hip Replacement Rehabilitation Coordination
- Conditions
- Hip Arthroplasty ReplacementHip Arthroplasty, TotalRehabilitationHip Osteoarthritis
- Registration Number
- NCT07201116
- Lead Sponsor
- Tulip Medicine
- Brief Summary
This study tests whether a mobile phone app with mapping technology can help patients find rehabilitation services faster after hip replacement surgery. After having their hip replaced, patients typically need several months of physical therapy to recover fully. However, many patients face long waiting times or don't know where to find rehabilitation services near them.
In this study, half of the patients will use a new mobile app that shows rehabilitation centers on a map, displays available appointment times, and allows patients to compare services and costs. The other half will receive standard care, where they must contact their family doctor to help find rehabilitation services.
The study will measure how quickly patients start rehabilitation after leaving the hospital, how well their hip functions after treatment, their quality of life, and pain levels. We will also look at whether the app is easy to use and cost-effective.
- Detailed Description
Total hip arthroplasty (hip replacement) is one of the most successful surgical procedures in modern orthopedics, with over 528 million people worldwide affected by osteoarthritis requiring joint replacement. The demand is projected to increase dramatically: 71% growth in the US by 2030 (635,000 procedures), 198% growth in Australia by 2046 (94,086 procedures), and 99-147% growth in Japan by 2030 depending on demographic groups.
Success of hip replacement surgery largely depends on timely access to rehabilitation services, particularly during the early recovery period (first 3-6 months post-surgery). Current medical rehabilitation principles emphasize early initiation, continuity, and seamless care coordination to optimize clinical outcomes. However, healthcare systems worldwide face significant challenges in organizing effective rehabilitation services.
The primary objective is to evaluate the effectiveness of implementing a GIS-integrated rehabilitation coordination platform for organizing early-stage rehabilitation after total hip arthroplasty. We hypothesize that using a specialized mobile application with integrated GIS components will eliminate information gaps, ensure equitable patient flow distribution among medical organizations, reduce time from surgical discharge to second-stage rehabilitation initiation, and consequently improve functional treatment outcomes while enhancing healthcare system resource utilization efficiency.
After discharge from surgical hospitals, patients often encounter an information vacuum regarding available rehabilitation services. Primary care physicians typically have limited knowledge of regional rehabilitation centers, severely restricting patient routing options. This leads to systematic violations of key rehabilitation principles - early initiation and continuity of care - negatively impacting surgical outcomes.
Kazakhstan's healthcare system exemplifies these challenges, with critical imbalances between rehabilitation service demand and supply. Leading national centers performing thousands of hip replacements annually can provide rehabilitation to only a small fraction of patients, creating waiting lists extending several months. This disproportion generates systematic risks and healthcare delivery violations, with over 5.9 million healthcare delivery defects identified in 2024, including inappropriate service volume increases, unjustified medical care provision, and deviations from clinical protocols.
Healthcare digitalization offers innovative solutions to these systemic problems. Geographic Information Systems (GIS) have been successfully applied in various medical fields for analyzing spatial distribution of medical resources, optimizing patient routing, and improving service accessibility. A rehabilitation coordination platform with integrated GIS components could fundamentally transform rehabilitation service organization by providing transparency regarding available services, real facility capacity, and care accessibility.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 142
- Age ≥45 years
- Primary and secondary (post-traumatic, developmental dysplasia, avascular necrosis) osteoarthritis of the hip requiring total hip arthroplasty
- First-time joint replacement surgery (no previous hip or knee replacement surgery)
- Scheduled for primary total hip arthroplasty within the next 1-2 days
- Cleared for surgery by anesthesiology and surgical teams
- Ability to understand study procedures and provide signed informed consent
- Fluency in Russian or Kazakh language
- Access to smartphone or tablet device with internet connectivity
- Ability to operate mobile applications independently or with family assistance
- Planned residence within Kazakhstan during the study period
- Willingness to attend scheduled follow-up assessments
- Previous total knee arthroplasty (either knee)
- Previous total hip arthroplasty (either hip)
- Revision hip arthroplasty
- Inflammatory arthritis (e.g., rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis)
- Hip fractures (femoral neck, intertrochanteric, or acetabular)
- Hip tumors (primary or metastatic bone tumors)
- Previous surgery on the index hip (e.g., osteotomy, arthroscopy, internal fixation)
- Severe cognitive impairment preventing informed consent or questionnaire completion
- Active psychiatric illness preventing participation in digital platform usage
- Participation in another clinical trial that might interfere with study outcomes
- High-risk surgery with expected prolonged hospitalization or ICU stay
- Medical contraindications to rehabilitation
- Planned revision surgery within 6 months
- Severe visual or hearing impairments preventing mobile application usage
- Inability to ambulate prior to surgery (wheelchair-bound patients)
- Inability to attend scheduled follow-up visits due to geographic constraints
- Patients scheduled for bilateral hip arthroplasty
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method Time to Rehabilitation Initiation 12 months from enrollment Time from discharge from surgical hospital to initiation of second-stage rehabilitation services, measured in days
Cost-effectiveness analysis (ICER) 12 months from enrollment Incremental cost-effectiveness ratio (ICER) calculated as the difference in mean direct medical costs between the intervention and control groups divided by the difference in quality-adjusted life years (QALYs) gained, where QALYs are derived from SF-12 scores converted to SF-6D utility values.
- Secondary Outcome Measures
Name Time Method Harris Hip Score Baseline, 6 weeks, 6 months, and 12 months from enrollment Functional outcome assessment measuring hip joint function, pain, and mobility.
SF-12 Quality of Life Score Baseline, 6 months, and 12 months from enrollment Quality of life assessment including Physical Component Summary and Mental Component Summary
Visual Analog Scale (VAS) Pain Score Baseline, 6 weeks, 6 months, and 12 months from enrollment Pain intensity assessment using a 0-10 scale where 0 represents no pain and 10 represents maximum possible pain.
System Usability Scale (SUS) Score 3 months and 6 months from enrollment Usability assessment of the Health-GIS platform for both patients and healthcare facilities.
Total Healthcare and Patient Costs 12 months from enrollment Direct Medical Costs, Direct Non-Medical Costs, Indirect Costs
Quality-Adjusted Life Years (QALY) 12 months from enrollment Health utility measured using SF-6D utility scores derived from SF-12 questionnaire, calculated using the area under the curve method over the 12-month study period
Trial Locations
- Locations (1)
NCJSC "Astana Medical University"
🇰🇿Astana, Kazakhstan
NCJSC "Astana Medical University"🇰🇿Astana, Kazakhstan