Assessment of Psychological Factors in Short-Stay Total Hip Arthroplasty Protocol

Oyer, Mark A.; Edelstein, Adam I.; Arnett, Nathan F.; Hardt, Kevin D.; Manning, David W.; Stover, Michael D.

doi:10.1016/j.arth.2020.10.056

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…Burgeoning evidence shows depression has a deleterious impact on orthopaedic clinical outcomes,6 and patients with depressive symptoms or a diagnosis of depression have worse outcomes than those without 7–15. Worse outcomes for major orthopaedic surgeries can be dire for patients, and include increased postoperative complications and revisions, greater likelihood of prolonged opioid use, and longer hospital stays, leading to higher patient- and organizational-costs and lower satisfaction 12,16–21…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9][10][11][12][13][14][15] Worse outcomes for major orthopaedic surgeries can be dire for patients, and include increased postoperative complications and revisions, greater likelihood of prolonged opioid use, and longer hospital stays, leading to higher patient-and organizational-costs and lower satisfaction. 12,[16][17][18][19][20][21] Illustrating the recognized importance, recent guidance for best practices in orthopaedic and other specialty settings recommends a collaborative approach that includes mental health providers (e.g., clinical social workers, psychologists) to screen patients for depressive symptoms, conduct assessments, provide brief intervention, and ensure adequate care coordination. 22 As national and payer focuses shift towards value-based care and patient experience (i.e.…”

Section: Introductionmentioning

confidence: 99%

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Integration of collaborative care model ameliorates population level COVID-19 Pandemic-related depressive symptoms among orthopaedic clinic patient population in US major metropolitan area

Lindsey

Dornan²,

McKelvey

2023

Current Orthopaedic Practice

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Background: In the United States, the COVID-19 pandemic resulted in a widespread mental health crisis. Overarchingly, medical clinics have been slow to adopt an interdisciplinary approach to patient care, though depression has been shown to negatively affect many clinical outcomes. With an ongoing, worsening mental health crisis in conjunction with a dramatic increase in demand for Total Joint Replacement anticipated by 2030, more routine depression screening and adequate mental health support is imperative. Our clinic implemented a Collaborative Care Model (CCM) in March of 2020 with a Licensed Clinical Social Worker (LCSW). Methods: Using data collected at our outpatient clinic between September 1, 2018 and August 31, 2021, we compared changes in Patient-Reported Outcome Measurements Information System (PROMIS) depression scores from the group of patients seen before CCM adoption (“pre-CCM”) with scores from the group after (“post-CCM”). Results: We found no between-group differences in PROMIS depression score changes. Increased pain interference was positively associated with increased depression in the pre-CCM group, but not in the post-CCM group. Conclusions: Our CCM was successful in mitigating for our patients the mental health crisis reflected among the general population during the lockdowns and uncertainty of the COVID-19 pandemic. The CCM also diminished further exacerbation of depression secondary to increased pain interference and the overall impact the pandemic had on healthcare operations. A CCM inclusive of an LCSW may also further support community resource linkage, complex care coordination, and assessment of other mental health conditions related to orthopaedic conditions or injury, such as anxiety and post-traumatic stress disorder.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Integration of collaborative care model ameliorates population level COVID-19 Pandemic-related depressive symptoms among orthopaedic clinic patient population in US major metropolitan area

Lindsey

Dornan²,

McKelvey

2023

Current Orthopaedic Practice

View full text Add to dashboard Cite

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“…Preoperative depression has been identified as one such risk factor, and has been shown to be potentially associated with increased risk of postoperative complications, 4 increased inpatient length of stay following surgery, 5 and an increased risk of 90-day hospital readmission. 6 However, other studies have demonstrated similar outcomes following THA in patients with higher levels of preoperative depression symptoms, 7,8 as well as significant improvement in these patients' depression symptom and the severity of their depression.…”

mentioning

confidence: 99%

Preoperative Depression is Not Associated with Inferior Outcomes following Total Hip Arthroplasty

Byrne

Durst

Rezzadeh

et al. 2023

The Journal of Hip Surgery

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Preexisting depression negatively impacts outcomes following total hip arthroplasty (THA). Patient-Reported Outcomes Measurement Information System (PROMIS) surveys are validated measures which quantify depression, pain, and physical function. We hypothesized that higher levels of preoperative PROMIS depression scores were associated with inferior outcomes following THA. A total of 247 patients underwent primary THA at the same institution by three arthroplasty surgeons between June 2018 and August 2020. PROMIS scores were collected preoperatively and at 6 weeks, 3 months, and 1 year postoperatively. Patients with preoperative PROMIS depression scores of 55 or more were considered depressed. The primary outcome measures were changes in PROMIS scores over time. Secondary outcomes were total morphine milligram equivalent (TME) and mean morphine equivalents per day (MME) received during admission, 90-day emergency room visits and hospital readmissions, and revisions within 2 years. Seventy-eight patients had preoperative PROMIS depression scores of 55 (PD) or more and 169 were not depressed (ND). PD patients were younger (PD: 62.0 [14.3] vs. ND: 66 [11.7], p = 0.028) at time of surgery and had higher TME (PD: 211.5 [320.9] vs. ND: 161.5 [375.9], p = 0.022) and MME (PD: 78.0 [71.6] vs. ND: 59.1 [67.3], p = 0.005) usage during hospitalization compared to ND patients. PD patients had higher preoperative PROMIS scores for pain (p < 0.001) and lower scores for function (p < 0.004). PD patients had improved PROMIS depression scores at all follow-up intervals (p < 0.01). All other changes in PROMIS pain and function scores were not different between groups. There were no significant differences in readmission rates or patients requiring revisions. Preoperative PROMIS depression scores of 55 or more do not negatively impact postoperative function, depression, or pain following THA, and are associated with greater improvement in depression. There also is not a higher rate of revisions or readmissions.

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Patients Who Have a Prior History of Pulmonary Embolism Require Increased Postoperative Care Following Total Joint Arthroplasty

Reynolds,

Issa,

Manning

2024

The Journal of Arthroplasty

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Assessment of Psychological Factors in Short-Stay Total Hip Arthroplasty Protocol

Cited by 4 publications

References 17 publications

Integration of collaborative care model ameliorates population level COVID-19 Pandemic-related depressive symptoms among orthopaedic clinic patient population in US major metropolitan area

Integration of collaborative care model ameliorates population level COVID-19 Pandemic-related depressive symptoms among orthopaedic clinic patient population in US major metropolitan area

Preoperative Depression is Not Associated with Inferior Outcomes following Total Hip Arthroplasty

Patients Who Have a Prior History of Pulmonary Embolism Require Increased Postoperative Care Following Total Joint Arthroplasty

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