TY - JOUR
T1 - Opportunities to optimise care and choice in joint replacement surgery using a digitally delivered, holistic PreHab pathway
AU - Bills, Eleanor R.
AU - Dimopoulos, Anastasia
AU - Burke, Anne Lj
AU - Collins, Kathryn L.
AU - Linedale, Ecushla C.
AU - Hume, Vicki
AU - Yeoh, Jackie
AU - Coles, Sharyn
AU - Nolan, Mandy
AU - Southam, Kate
AU - Thomas, Lesley
AU - Ramsey, Melanie
AU - Andrews, Jane M.
PY - 2024/5/1
Y1 - 2024/5/1
N2 - PURPOSE: To describe the implementation and evaluation of a hospital-initiated, community-based, digital prehabilitation program (My PreHab Program: MPP) for adults referred for elective joint replacement. METHODS: MPP was implemented July 2022 and comprises a personalised digital health screen that guides the provision of self-management resources. Adults (>18 years) referred and accepted, or already waitlisted, for total knee/hip replacement surgery were eligible. Individuals requiring category 1 (urgent) or emergency surgery and those without a mobile phone were excluded. Implementation and intervention outcome measures (program adoption, equity of reach, fidelity, acceptability, appropriateness, feasibility, engagement, preliminary surgical outcomes) were explored via study-specific measures and hospital records. RESULTS: Of those invited (N = 689), 77.8% participated. Participants and non-participants were similar in key demographic variables except regional invitees were more likely to participate than metropolitan (88.0% vs 75.4%, p = .002) and non-participants tended to be older (median age = 69.0 vs 64.0, p = .005). Participants reported on average four modifiable risk factors: most commonly chronic pain (79.1%), obesity (57.3%), and frailty (40.9%). Most participants (80.4%) reviewed all resources provided and reported action/intention to address issues identified (90.9%). Participants perceived MPP as acceptable (3.2/5), appropriate (3.3/5), and feasible (3.4/5). Early trends for participants progressing to surgery (n = 33) show a reduced length of stay (MPP = 4.3, baseline = 5.3 days). CONCLUSION: MPP demonstrated high adoption, fidelity, and participant engagement. It is acceptable, appropriate and feasible and has the potential to be scaled-up digitally at low-cost. Modifiable risk factors were prevalent and early indications suggest this preoperative intervention may benefit both patients and the healthcare system.
AB - PURPOSE: To describe the implementation and evaluation of a hospital-initiated, community-based, digital prehabilitation program (My PreHab Program: MPP) for adults referred for elective joint replacement. METHODS: MPP was implemented July 2022 and comprises a personalised digital health screen that guides the provision of self-management resources. Adults (>18 years) referred and accepted, or already waitlisted, for total knee/hip replacement surgery were eligible. Individuals requiring category 1 (urgent) or emergency surgery and those without a mobile phone were excluded. Implementation and intervention outcome measures (program adoption, equity of reach, fidelity, acceptability, appropriateness, feasibility, engagement, preliminary surgical outcomes) were explored via study-specific measures and hospital records. RESULTS: Of those invited (N = 689), 77.8% participated. Participants and non-participants were similar in key demographic variables except regional invitees were more likely to participate than metropolitan (88.0% vs 75.4%, p = .002) and non-participants tended to be older (median age = 69.0 vs 64.0, p = .005). Participants reported on average four modifiable risk factors: most commonly chronic pain (79.1%), obesity (57.3%), and frailty (40.9%). Most participants (80.4%) reviewed all resources provided and reported action/intention to address issues identified (90.9%). Participants perceived MPP as acceptable (3.2/5), appropriate (3.3/5), and feasible (3.4/5). Early trends for participants progressing to surgery (n = 33) show a reduced length of stay (MPP = 4.3, baseline = 5.3 days). CONCLUSION: MPP demonstrated high adoption, fidelity, and participant engagement. It is acceptable, appropriate and feasible and has the potential to be scaled-up digitally at low-cost. Modifiable risk factors were prevalent and early indications suggest this preoperative intervention may benefit both patients and the healthcare system.
KW - arthroplasty
KW - health promotion
KW - length of stay
KW - patients
KW - perioperative medicine
KW - postoperative complications
KW - state medicine
UR - http://www.scopus.com/inward/record.url?scp=85193674523&partnerID=8YFLogxK
U2 - 10.1177/10225536241234032
DO - 10.1177/10225536241234032
M3 - Article
C2 - 38767054
AN - SCOPUS:85193674523
SN - 2309-4990
VL - 32
SP - 10225536241234032
JO - Journal of orthopaedic surgery (Hong Kong)
JF - Journal of orthopaedic surgery (Hong Kong)
IS - 2
ER -