Effects of interdisciplinary preoperative sessions for preparation, education, and follow-up on the length of stay of patients undergoing total hip or knee replacement.
Summary description of the study
The shortening of lengths of stay requires a rethinking of perioperative management (around the operative period), which precedes and immediately follows the intervention, in order to ensure good patient preparation and adequate postoperative follow-up. The aim of this study is to evaluate in patients undergoing total hip or knee replacement the effect on length of stay of adding an individualized pre-perioperative preparation and education session to the existing protocol in the musculoskeletal department at the Lausanne University Hospital (CHUV). The implementation of a targeted and minimally burdensome immediate postoperative follow-up could help improve the detection of complications, prevent avoidable readmissions, enhance pain management and adverse events, support the patient, and address difficulties encountered in their living environment. However, the actual added value for the patient and the healthcare system still needs to be clarified. Since the needs and resources of patients vary, it would also be useful to better determine the profile of patients for whom a preoperative and postoperative session provides significant added value.
(BASEC)
Intervention under investigation
The control group receives the standard care in place in the service, which includes only a group information session.
The intervention group A receives, in addition to a group information session, an individualized preparation and education interview.
The intervention group B receives, in addition to a group information session, an individualized preparation and education interview from the group information session and a remote postoperative follow-up.
(BASEC)
Disease under investigation
In Switzerland, in 2017, 12.4% of the Swiss population suffered from osteoarthritis. In 2019, the SIRIS registry for hip and knee implants recorded 20,077 total hip prostheses and 15,453 total knee prostheses implanted in Switzerland. The improvement of overall practices in prosthetic surgery, the pressure on healthcare costs, and the shift to outpatient care have led to a shortening of lengths of stay.
(BASEC)
The study includes: Male and female patients admitted to the musculoskeletal department of the Lausanne University Hospital (CHUV) during the study period for the implantation of a primary total hip prosthesis (THP) or primary total knee prosthesis (TKP), who present a RAPT score >6 (Risk Assessment and Prediction Tool), indicative of a likely return directly home upon discharge from hospitalization. (BASEC)
Exclusion criteria
Exclusion criteria include: - A high likelihood of not being able to return directly home - A summons for a knee prosthesis change, given the potentially different postoperative outcomes. - Inability to provide informed consent or to respond knowledgeably to questionnaires for reasons of language or cognitive impairments, as reported in the medical record. (BASEC)
Trial sites
Lausanne
(BASEC)
Sponsor
HESAV
(BASEC)
Contact
Contact Person Switzerland
Pichonnaz Claude
021 316 81 26
claude.pichonnaz@clutterhesav.chHaute École de Santé - Vaud (HESAV)
(BASEC)
General Information
Haute Ecole de Sant? Vaud
(ICTRP)
Scientific Information
Haute Ecole de Sant? Vaud
(ICTRP)
Name of the authorising ethics committee (for multicentre studies, only the lead committee)
Ethics Committee Vaud
(BASEC)
Date of authorisation
11.08.2022
(BASEC)
ICTRP Trial ID
NCT05452161 (ICTRP)
Official title (approved by ethics committee)
Effects of Preoperative Education, and Follow-up Sessions of Patients With Total Hip and Knee Arthroplasty (ESIPPES) (BASEC)
Academic title
Effects of Interdisciplinary Preoperative Preparation, Education, and Follow-up Sessions on Length of Stay in Hospital and Clinical Outcomes of Patients Undergoing Total Hip or Knee Replacement Surgery. (ICTRP)
Public title
Effects of Preoperative Education, and Follow-up Sessions of Patients With Total Hip and Knee Arthroplasty (ESIPPES) (ICTRP)
Disease under investigation
Arthroplasty, Replacement, Hip;Arthroplasty, Replacement, Knee (ICTRP)
Intervention under investigation
Other: Control group;Other: Intervention group A;Other: Intervention group B (ICTRP)
Type of trial
Interventional (ICTRP)
Trial design
Allocation: Randomized. Intervention model: Parallel Assignment. Primary purpose: Treatment. Masking: None (Open Label). (ICTRP)
Inclusion/Exclusion criteria
Gender: All
Maximum age: N/A
Minimum age: 18 Years
Inclusion Criteria:
- 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
Exclusion Criteria:
- 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
(ICTRP)
not available
Primary and secondary end points
Hospital stay (ICTRP)
Readmission rate;Destination at discharge;Postoperative pain;Complications;Joint function of hip or knee;Joint function of hip;Joint function of knee;Mobility of hip or knee;Anxiety and Depression;Representation of pain;Expectations concerning the prosthesis and subjective function;Satisfaction with care;Quality of life EuroQol 5 Dimensions (EQ-5D) questionnaire (ICTRP)
Registration date
not available
Incorporation of the first participant
not available
Secondary sponsors
not available
Additional contacts
Claude Pichonnaz, Haute Ecole de Sant? Vaud (ICTRP)
Secondary trial IDs
ESIPPES (ICTRP)
Results-Individual Participant Data (IPD)
not available
Further information on the trial
https://clinicaltrials.gov/ct2/show/NCT05452161 (ICTRP)
Results of the trial
Results summary
lay-summary.pdfLink to the results in the primary register
not available