Development and Measurement of the Effects of a Digital Education Solution for Patients Undergoing Total Hip or Knee Arthroplasty
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 160
- 试验地点
- 1
- 主要终点
- Number of patient calls to the remote care center (CTS)
研究概览
简要总结
This study aims to evaluate the effectiveness of a digital patient education solution, CHUVeduc@home, in improving preoperative preparation for patients undergoing total hip or knee arthroplasty. In Switzerland, many patients receive joint replacements each year to relieve osteoarthritis-related pain. With shorter hospital stays, adequate preparation before surgery has become increasingly important.
A total of 160 patients will be randomized into two groups:
Intervention group: access to CHUVeduc@home before surgery. Control group: standard preoperative preparation (group information session and consultation).
All participants will complete questionnaires through the application. No additional visits are required. The intervention lasts approximately 12 weeks.
The primary goal is to determine whether digital education increases patient knowledge, confidence, and satisfaction, and facilitates recovery and return home after surgery. Participation is voluntary and can be withdrawn at any time.
详细描述
Study Purpose:
The purpose of this study is to improve preparation for hip or knee surgery. Each year in Switzerland, a large number of individuals receive a hip or knee prosthesis to relieve pain caused by osteoarthritis. Through enhanced perioperative care programs such as the one implemented at CHUV, the length of hospital stay has decreased, making preoperative preparation increasingly important.
Current Practice:
Current practice includes participation in a group information session and a preoperative consultation. However, retaining all provided information can be challenging. To support more effective preparation, the investigators will evaluate a digital application called CHUVeduc@home, integrated within CHUV@home, which is already used during postoperative recovery.
Features of the Application:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •male and female patients admitted to the CHUV musculoskeletal department during the study period
- •primary total hip replacement or primary total knee replacement
- •a Risk Assessment and Prediction Tool (RAPT) score >6
排除标准
- •a RAPT score <6,
- •knee/hip arthroplasty revision surgery
- •inability to give informed consent or answer questionnaires knowledgeably due to language or cognitive impairment as reported in the medical record
研究组 & 干预措施
Intervention Group: access to CHUVeduc@home before surgery
Intervention Group - Pathway with CHUVeduc@home This group follows the standard preoperative pathway, complemented by personalized digital preparation through the CHUVeduc@home application, available 2 to 6 weeks before surgery.
干预措施: Digital Preoperative Education with CHUVeduc@home (Behavioral)
Control Group - Standard Care Pathway
Control Group - Standard Care Pathway This group follows the standard clinical care pathway established at CHUV for patients undergoing total hip or knee arthroplasty.
The main steps include:
- Consultation with the surgeon
- Group information session
- Preoperative consultation
- Hospital stay for surgery
- Discharge and return home
- Telemonitoring with CHUV@home after surgery
- Postoperative follow-up visit at 6 weeks
Participants in this group also use the CHUV@home application to complete study-specific questionnaires; however, they do not receive any additional educational content prior to surgery.
干预措施: Standard Care Pathway (Behavioral)
结局指标
主要结局
Number of patient calls to the remote care center (CTS)
时间窗: During the intervention period (from inclusion until surgery, up to 6 weeks)
The primary outcome is the total number of calls initiated by patients to the remote care support center (CTS) during the intervention period. This measure will assess the impact of the digital education tool on patient autonomy and the need for additional support. A lower number of calls is expected to reflect improved patient preparation and self-management.
Reason for contacts, the severity of alerts
时间窗: During the intervention period (from inclusion until surgery, up to 6 weeks)
This secondary objective aims to analyze the specific reasons for patient contacts, assess the severity of alerts generated, and evaluate the potential financial benefits associated with a decrease in the number of contacts, thereby providing a comprehensive understanding of the impact of the telemonitoring intervention.
次要结局
- Patient-reported health status and quality of life (EQ-5D-5L)(At preadmission (3 days before surgery), and 6 weeks postoperatively)
- Patient satisfaction (ANQ questionnaire)(1 week after hospital discharge)
- Patient engagement (Patient Activation Measure [PAM-13](At baseline during the intervention period , at preadmission (3 days before surgery) and 6 weeks postoperatively)
- Physical activity (International Physical Activity Questionnaire [IPAQ])(At baseline during the intervention period and 6 weeks postoperatively)
- Patients' expectations regarding surgery outcomes (Hospital for Special Surgery Knee/Hip Expectations Survey [HSS Knee or Hip])(At baseline (prior to surgery) during the intervention period)
- Fear and anxiety related to surgery (Survey of Surgical Fear [SSF])(At baseline during the intervention period and at preadmission (3 days before surgery))
- Pain (Numeric Rating Scale for pain)(At hospital discharge (Day 3-5) and at 6 weeks postoperatively)
- Qualitative analysis of patient messages to the remote care team (CTS)(During the intervention period (from inclusion until surgery, up to 12 weeks))
- Patient-reported Oxford Knee Score [OKS] or Oxford Hip Score [OHS])(At preadmission (3 days before surgery) and 6 weeks postoperatively)
- Patient satisfaction with mobile application (uMARS scale)(At preadmission (3 days before surgery))
- Health literacy, French eHealth Literacy Scale [F-eHEALS])(At baseline during the intervention period and 6 weeks postoperatively)
- Length of stay (days of hospitalization)(At hospital discharge)
- Postoperative complications (clinical assessment)(At hospital discharge (Day 3-5) and at 6 weeks postoperatively)
- Hospital readmission (yes/no)(At 6 weeks postoperatively)
- Stratified analysis of intervention effectiveness by patient characteristics(At the end of the intervention period (up to 12 weeks after inclusion))
研究者
Claude Pichonnaz
Associate Professor UAS, Ph.D
Haute Ecole de Santé Vaud