Cost-Effectiveness of Web-Based Follow Ups
Complications following total joint arthroplasty are rare, and the majority of follow-up visits are routine. The technology now exists to conduct annual follow-up assessments without having to physically see the patient.
This study will investigate the cost-effectiveness of web-based follow-up assessments compared to standard in-clinic follow-ups. We will also assess patient satisfaction, preference, and the validity of the web-based follow up assessments. Patients coming up to their 1 year follow-up or greater will be randomized to either the web-based group or the usual care group.
Web-based patients will complete all questionnaires using an online database system, and have their x-ray taken at their local radiology facility. The surgeon will review radiographs online. If there are any concerns with the x-ray or responses to questionnaires, arrangements will be made for the patient to be seen at the clinic. Patients in the Usual Care group will come into the clinic for their follow-up assessment and have their x-ray taken at University Hospital as usual.
Online assessment could significantly decrease wait times in orthopaedic clinics, as well as increase availability for OR time and new consultations. This approach could also potentially reduce patient burden by decreasing travel distances, financial burden and time requirements.
Osteoarthritis in the Knee Joint
Osteoarthritis in the Hip Joint
|Study Design:||Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Health Services Research
|Official Title:||Cost-Effectiveness of Web-Based Follow Up Following Total Joint Arthroplasty|
- Cost-effectiveness [ Time Frame: one year ] [ Designated as safety issue: No ]
- Harris Hip Score [ Time Frame: one year ] [ Designated as safety issue: No ]
- Western Ontario and McMaster Osteoarthritis Index (WOMAC) [ Time Frame: one year ] [ Designated as safety issue: No ]
- SF-12 [ Time Frame: one year ] [ Designated as safety issue: No ]
- Adverse events [ Time Frame: one year ] [ Designated as safety issue: Yes ]
|Study Start Date:||February 2010|
|Study Completion Date:||March 2011|
|Primary Completion Date:||March 2011 (Final data collection date for primary outcome measure)|
The patient will undergo xrays at the closest PACs enabled imaging centre and will login and answer questions online. The surgeon will review the images and patient responses and determine whether the patient needs to be seen more urgently or a per routine.
Patients who are at least 2 years following knee or hip replacement will complete a questionnaire online and routine x-rays at a PACS enabled imaging center. The patient's surgeon will receive an email from the database summarizing the patient's responses to key questions and will review the x-rays. The surgeon will determine whether the patient needs to be seen in-person.
Active Comparator: in-person
Patients will attend their follow-up appointments in-person as per usual
Follow-up appointments will be completed in-person as per usual
Please refer to this study by its ClinicalTrials.gov identifier: NCT01079572
|London Health Sciences Centre - University Hospital|
|London, Ontario, Canada, N6G 1H1|