The Effect of an App for Day-to-Day Postoperative Care Education on Patients With Total Knee Replacement: Randomized Controlled Trial
| Autor: | Frederik Okke Lambers Heerspink, Rudolf B Kool, Walter van der Weegen, Willem-Jan Marijnissen, Loes Janssen, Bregje J.W. Thomassen, Babette C. van der Zwaard, Thomas Timmers, Jan-Willem A. Swen, Dirk Das, Adriaan Plat, Gerjon Hannink |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Telemedicine medicine.medical_specialty self-management ehealth Health Informatics Information technology smartphone patient education Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] law.invention 03 medical and health sciences All institutes and research themes of the Radboud University Medical Center 0302 clinical medicine Quality of life (healthcare) Randomized controlled trial Patient Education as Topic law Surveys and Questionnaires Health care Medicine Humans 030212 general & internal medicine Arthroplasty Replacement Knee Aged Netherlands Postoperative Care 030222 orthopedics Original Paper Self-management business.industry Repeated measures design Middle Aged T58.5-58.64 Mobile Applications Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] Clinical trial Treatment Outcome Physical therapy Female telemedicine Public aspects of medicine RA1-1270 business Patient education |
| Zdroj: | JMIR mHealth and uHealth, 7 JMIR mHealth and uHealth JMIR mHealth and uHealth, Vol 7, Iss 10, p e15323 (2019) JMIR mHealth and uHealth, 7, 10 |
| ISSN: | 2291-5222 |
| DOI: | 10.2196/15323 |
| Popis: | Background Patients who undergo primary Total Knee Replacement surgery (TKR) are often discharged within 1-3 days after surgery. With this relatively short length of hospital stay, a patient’s self-management is a crucial factor in optimizing the outcome of their treatment. In the case of TKR, self-management primarily involves adequate pain management, followed by physiotherapy exercises and daily self-care activities. Patients are educated on all these topics by hospital staff upon discharge from the hospital but often struggle to comprehend this information due to its quantity, complexity, and the passive mode of communication used to convey it. Objective This study primarily aims to determine whether actively educating TKR patients with timely, day-to-day postoperative care information through an app could lead to a decrease in their level of pain compared to those who only receive standard information about their recovery through the app. In addition, physical functioning, quality of life, ability to perform physiotherapy exercises and daily self-care activities, satisfaction with information, perceived involvement by the hospital, and health care consumption were also assessed. Methods A multicenter randomized controlled trial was performed in five Dutch hospitals. In total, 213 patients who had undergone elective, primary, unilateral TKR participated. All patients had access to an app for their smartphone and tablet to guide them after discharge. The intervention group could unlock day-to-day information by entering a personal code. The control group only received weekly, basic information. Primary (level of pain) and secondary outcomes (physical functioning, quality of life, ability to perform physiotherapy exercises and activities of daily self-care, satisfaction with information, perceived involvement by the hospital, and health care consumption) were measured using self-reported online questionnaires. All outcomes were measured weekly in the four weeks after discharge, except for physical functioning and quality of life, which were measured at baseline and at four weeks after discharge. Data was analyzed using Student t tests, chi-square tests, and linear mixed models for repeated measures. Results In total, 114 patients were enrolled in the intervention group (IG) and 99 in the control group (CG). Four weeks after discharge, patients in the IG performed significantly better than patients in the CG on all dimensions of pain: pain at rest (mean 3.45 vs mean 4.59; P=.001), pain during activity (mean 3.99 vs mean 5.08; P Conclusions In the four weeks following TKR, the active and day-to-day education of patients via the app significantly decreased their level of pain and improved their physical functioning, quality of life, ability to perform physiotherapy exercises and activities of daily self-care, satisfaction with information, perceived involvement by the hospital, and health care consumption compared to standard patient education. Given the rising number of TKR patients and the increased emphasis on self-management, we suggest using an app with timely postoperative care education as a standard part of care. Trial Registration Netherlands Trial Register NTR7182; https://www.trialregister.nl/trial/6992 |
| Databáze: | OpenAIRE |
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