Comparing an eHealth Program (My Hip Journey) With Standard Care for Total Hip Arthroplasty: Randomized Controlled Trial

Abstract

Background The role of eHealth programs to support patients through surgical pathways, including total hip arthroplasty (THA), is rapidly growing and offers the potential to improve patient engagement, self-care, and outcomes. Objective The aim of this study is to compare the effects of an eHealth program (intervention) versus standard care for pre- and postoperative education on patient outcomes for primary THA. Methods A prospective parallel randomized controlled trial with two arms (standard care and standard care plus access to the eHealth education program) was conducted. Participants included those who underwent THA. Outcome measures were collected preadmission, at 6 weeks, and at 3 and 6 months after surgery. The primary outcome was the Hip Dysfunction and Osteoarthritis Outcome Score. Secondary outcomes were a 5-level 5-dimension quality of life measure and the self-efficacy for managing chronic disease scale. Demographic and clinical characteristics were also collected. A satisfaction survey was completed by all participants 6 weeks after surgery, and those in the intervention arm completed an additional survey specific to the eHealth program. Results A total of 99 patients were recruited: 50 in the eHealth program (intervention) and 49 in standard care (control). Clinical improvements were demonstrated in both groups across all time points. Per-protocol analysis demonstrated no differences between the groups for all outcome measures across all time points. Participants in the eHealth program reported that the program was accessible, that they felt comfortable using it, and that the information was helpful. Conclusions This study demonstrated that the eHealth program, in addition to standard care, had no additional benefit to THA recovery compared with standard care alone. The study found that the eHealth program was highly valued by participants, and it supported the preoperative preparation, recovery, and postoperative rehabilitation of participants. Trial Registration Australian New Zealand Clinical Trial Registry ACTRN12617001433392; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373657

Process of Posthospital Care Involving Telemedicine Solutions for Patients after Total Hip Arthroplasty

“…Remote virtual rehabilitation aroused growing interest in the last decades, and its role has gained importance following the recent spread of COVID19 pandemic [ 31 ]. eHealth programs can provide individualized patient care at the preoperative, perioperative and postoperative stages and have the potential to improve patient engagement, self-care and outcomes across the surgical pathway [ 32 ].…”

Telemedicine Technologies Selection for the Posthospital Patient Care Process after Total Hip Arthroplasty

“…The users of telemedicine technologies in posthospital patient care process after THA are patients (at every stage of the process), physicians [ 13 , 14 , 23 , 24 , 38 ], physiotherapists [ 15 , 16 , 24 , 25 , 26 ], surgeons, [ 17 , 18 , 25 ], surgeon’s administrative assistants [ 17 ], health care team [ 27 ], and rehabilitation center [ 28 ].…”

My hip journey: A qualitative study of patients’ experiences of an eHealth program for patient preparation and recovery from hip replacement surgery

“…A qualitative descriptive approach was used for this study to build on the results of a randomised control trial comparing the eHealth program to standard care for total hip arthroplasty (Saunders et al, 2021). The rationale for conducting the qualitative component was so we could explore with patient users their experiences of using the eHealth program.…”

“…The eHealth program was designed for patients undergoing hip arthroplasty based on the Go Well Health surgical platform. It provided resources (fact sheets, instructional videos and exercise videos) for patients about the pre‐ and post‐operative care requirements for their surgery (Saunders et al, 2021). Patients accessed the eHealth program via a weblink with a username and password and this was available two weeks prior to surgery until 30 days post‐surgery.…”

“…The eHealth program was designed for patients undergoing hip arthroplasty based on the Go Well Health surgical platform. It provided resources (fact sheets, instructional videos and exercise videos) for patients about the pre-and postoperative care requirements for their surgery (Saunders et al, 2021).…”