To what extent do current total hip and knee replacement patient information resources adhere to enhanced recovery after surgery principles?

Wainwright, Tom; Burgess, Louise

doi:10.1016/j.physio.2018.05.002

Cited by 15 publications

(14 citation statements)

References 42 publications

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“…However, the experience of the patient undergoing rehabilitation following THR and TKR can be highly variable ( 1 ). This may be due to the fact that written materials and patient information sheets have been found to vary in quality ( 2 ) and readability ( 3 ). Meanwhile, technical advances (in particular the widespread use of smartphones) have indicated that smartphone apps may have potential in enhancing rehabilitation and encouraging self-management following THR/TKR.…”

Section: Introductionmentioning

confidence: 99%

Readability of Information on Smartphone Apps for Total Hip Replacement and Total Knee Replacement Surgery Patients

Bahadori

Wainwright

Ahmed

2019

Journal of Patient Experience

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Background: Readability is a vital component of health information and providing this material at an appropriate literacy level may positively influence patient experience. Objective: To assess the readability of the information provided within total hip replacement and total knee replacement apps to understand more about the impact this could have on patients. Method: A systematic search was conducted across the 5 most popular smartphone app stores: iTunes, Google Play, Windows Mobile, Blackberry App World, and Nokia Ovi. Apps were identified for screening if they: targeted total hip replacement or total knee replacement patients; were free of charge; and were in English. App readability assessment was conducted independently by 3 reviewers using the Gunning Fog Index, the Flesch Reading Ease Score, and the Flesch-Kincaid Grade Level. Results: Fifteen apps met the inclusion criteria. Only one app was found “easy to read” (My THR). Conclusion: Findings suggest that the overall readability of information provided is written at a level which is difficult for patients to comprehend. App developers should engage patients in the design process of their apps, in order to enhance patient experience and for the potential impact of these innovative health technologies to be truly realized.

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Section: Introductionmentioning

confidence: 99%

Readability of Information on Smartphone Apps for Total Hip Replacement and Total Knee Replacement Surgery Patients

Bahadori

Wainwright

Ahmed

2019

Journal of Patient Experience

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“…In the short term, part of these issues can be resolved by proper patient or family education, which is provided within the ERAS pathway, and it is perceived as exhaustive by the professionals involved (“Is patient-information about the technology exhaustive?”). In order to take the best advantage from patient education [ 65 , 74 , 77 ], information must be clear, accessible, and the more patient-centred as possible [ 78 ]. In the long term, improved coordination between healthcare institutions and dedicated training to the professionals involved may also play a positive role.…”

Section: Discussionmentioning

confidence: 99%

Introducing enhanced recovery after surgery in a high-volume orthopaedic hospital: a health technology assessment

Vanni

Foglia

Pennestrì

et al. 2020

BMC Health Serv Res

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Background: The number of patients undergoing joint arthroplasty is increasing worldwide. An Enhanced Recovery After Surgery (ERAS) pathway for hip and knee arthroplasty was introduced in an Italian high-volume research hospital in March 2018. Methods: The aim of this mixed methods observational study is to perform a health technology assessment (HTA) of the ERAS pathway, considering 938 procedures performed after its implementation, by means of a hospitalbased approach derived from the EUnetHTA (European Network for Health Technology Assessment) Core Model. The assessment process is based on dimensions of general relevance, safety, efficacy, effectiveness, economic and financial impact, equity, legal aspects, social and ethical impact, and organizational impact. A narrative review of the literature helped to identify general relevance, safety and efficacy factors, and a set of relevant sub-dimensions submitted to the evaluation of the professionals who use the technology through a 7-item Likert Scale. The economic and financial impact of the ERAS pathway on the hospital budget was supported by quantitative data collected from internal or national registries, employing economic modelling strategies to identify the amount of resources required to implement it. Results: The relevance of technology under assessment is recognized worldwide. A number of studies show accelerated pathways to dominate conventional approaches on pain reduction, functional recovery, prevention of complications, improvements in tolerability and quality of life, including fragile or vulnerable patients. Qualitative surveys on clinical and functional outcomes confirm most of these benefits. The ERAS pathway is associated with a reduced length of stay in comparison with the Italian hospitalization average for the same procedures, despite the poor spread of the pathway within the country may generate postcode inequalities. The economic analyses show how the resources invested in training activities are largely depreciated by benefits once the technology is permanently introduced, which may generate hospital cost savings of up to 2054,123.44 € per year. Conclusions: Galeazzi Hospital's ERAS pathway for hip and knee arthroplasty results preferable to traditional approaches following most of the HTA dimensions, and offers room for further improvement. The more comparable practices are shared, the before this potential improvement can be identified and addressed.

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“…This study was conducted by adopting a qualitative data collection method which informed a quantitative data analysis procedure, a method previously used to evaluate the content of patient information leaflets [13]. Patient information leaflets from English National Health Service (NHS) hospitals performing lumbar spine surgery were sourced, and then a content analysis was conducted to collect relevant data from these resources.…”

Section: Methodsmentioning

confidence: 99%

“…A content analysis was then used to collect data from the patient information leaflets, informed by previous studies that have evaluated patient information [13,16,17]. Each patient information leaflet was systematically reviewed by two researchers (LB and ML) and the data was recorded in a Microsoft Excel (2010) spreadsheet.…”

Section: Methodsmentioning

confidence: 99%

“…They are provided to patients with the aim of providing important consumer health information in an easy to read format. Although information leaflets may improve patients’ knowledge, satisfaction and adherence to treatment [11], their quality and effectiveness has been criticised [12], and a lack of adherence to ERAS principles has been highlighted in orthopaedic resources [13]. Patient leaflets can be used to disseminate important postoperative rehabilitation information which can be difficult to retain during face-to-face meetings with clinicians.…”

Section: Introductionmentioning

confidence: 99%

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A Critical Analysis of the Exercise Prescription and Return to Activity Advice That Is Provided in Patient Information Leaflets Following Lumbar Spine Surgery

2019

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Background and objectives: Lumbar spine surgery may be considered if pharmacologic, rehabilitation and interventional approaches cannot provide sufficient recovery from low back-related pain. Postoperative physiotherapy treatment in England is often accompanied by patient information leaflets, which contain important rehabilitation advice. However, in order to be an effective instrument for patients, the information provided in these leaflets must be up to date and based on the best available evidence and clinical practice. This study aims to critically analyse the current postoperative aspects of rehabilitation (exercise prescription and return to normal activity) that are provided in patient information leaflets in England as part of an evaluation of current practice following lumbar spine surgery. Materials and Methods: Patient information leaflets from English National Health Service (NHS) hospitals performing lumbar spine surgery were sourced online. A content analysis was conducted to collect data on postoperative exercise prescription and return to normal activities. Results: Thirty-two patient information leaflets on lumbar surgery were sourced (fusion, n = 11; decompression, n = 15; all lumbar procedures, n = 6). Many of the exercises prescribed within the leaflets were not based on evidence of clinical best practice and lacked a relationship to functional activity. Return to normal activity advice was also wide ranging, with considerable variation in the recommendations and definitions provided. Conclusions: This study highlights a clear variation in the recommendations of exercise prescription, dosage and returning to normal activities following lumbar spine surgery. Future work should focus on providing a consistent and patient-centred approach to recovery.

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To what extent do current total hip and knee replacement patient information resources adhere to enhanced recovery after surgery principles?

Cited by 15 publications

References 42 publications

Readability of Information on Smartphone Apps for Total Hip Replacement and Total Knee Replacement Surgery Patients

Readability of Information on Smartphone Apps for Total Hip Replacement and Total Knee Replacement Surgery Patients

Introducing enhanced recovery after surgery in a high-volume orthopaedic hospital: a health technology assessment

A Critical Analysis of the Exercise Prescription and Return to Activity Advice That Is Provided in Patient Information Leaflets Following Lumbar Spine Surgery

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