Osteoarthritis Clinical Trial
Official title:
A Randomized Controlled Trial to Establish Realistic Patient Expectations of Total Knee Arthroplasty
Patients from the Joint Replacement Institute scheduled to undergo primary total knee
replacement surgery (TKR) will be invited to participate at the Pre Admission Clinic (PAC),
University Hospital, London Health Sciences Centre. Baseline questionnaires of preoperative
measures and demographic information and a cost analysis will be explored at the PAC for
each patient. Patients will be randomized with the treatment group receiving access to a
web-based, e-learning intervention. Postoperatively all patients will be asked to complete
questionnaires at 6 weeks, 3 months and 1 year after their TKR surgery.
Objectives
The first primary objective is to compare the effect of two methods of providing patient
education on expectations of surgical outcome in total knee replacement (TKR) patients.
The second objective is to compare the effect of two methods of providing patient education
on satisfaction with surgical outcome in TKR patients.
The intervention of interest is an e-learning education program that spans both the
preoperative and postoperative time period. The control condition will be the current method
of patient education provided at the hospital study site.
Hypothesis: Objective One
More change in patient expectations will occur between preoperative and one year
postoperative in the e-learning educational intervention group.
Hypothesis: Objective Two
More change in patient satisfaction will occur between preoperative and one year
postoperative in the e-learning educational intervention group.
This will be a single centre prospective experimental study, involving seven orthopaedic
surgeons and their patients undergoing total knee replacement (TKR). A consecutive sample of
elective primary TKR patients will be invited to participate from London Health Sciences
Centre, University Hospital, London, Ontario, Canada. Additionally, patient hospital charts
will be accessed to establish the concordance between co-morbidities recorded in patient
history and self-report measures of co-morbidities.
Interested patients will be randomized into one of two groups. Group 1 (intervention) will
receive the e-learning educational intervention in addition to the current method of patient
education. It will commence at the pre-admission clinic and continue to the study end-point
of 1-year postoperative. Group 2 (control) will receive the current, existing method
utilized by each of the seven orthopaedic surgeons for their patient education. At
pre-admission, patients are provided a 31 page hard copy of My Guide to Total Knee Joint
Replacement (Revised January, 2008) and they are made aware of an electronic copy of this
document available at the following website:
http://www.jointreplacementinstitute.com/patients.html
The assumption is that patients can and will read this document to educate themselves about
their TKR surgery. The interactive e-learning patient education intervention extends beyond
simple accessibility to information and includes interactive features. The intervention
spans surgery and rehabilitation aftercare with patients undergoing TKR. Measurements will
take place at pre-admission before any preoperative education takes place and at 6 weeks, 3
months and 1 year after TKR surgery. Patients will have the option of completing
questionnaires online using Empower or hard copy sent by mail. They will also receive
reminders by email or phone about completing the questionnaires.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Health Services Research
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