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接受择期髋关节和膝关节置换手术的患者的数字化患者就诊流程解决方案:一项实用随机对照试验方案。

The digital patient journey solution for patients undergoing elective hip and knee arthroplasty: Protocol for a pragmatic randomized controlled trial.

机构信息

Research Group of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.

Oulu University Hospital, Oulu, Finland.

出版信息

J Adv Nurs. 2020 Jun;76(6):1436-1448. doi: 10.1111/jan.14343. Epub 2020 Mar 15.

Abstract

AIM

To describe a randomized controlled trial (RCT) protocol that will evaluate the effectiveness of a digital patient journey (DPJ) solution in improving the outcomes of patients undergoing total hip and knee arthroplasty.

BACKGROUND

There is an urgent need for novel technologies to ensure sustainability, improve patient experience, and empower patients in their own care by providing information, support, and control.

DESIGN

A pragmatic RCT with two parallel arms.

METHODS

The participants randomized assigned to the intervention arm (N = 33) will receive access to the DPJ solution. The participants in the control arm (N = 33) will receive conventional care, which is provided face to face by using paper-based methods. The group allocations will be blinded from the study nurse during the recruitment and baseline measures, as well as from the outcome assessors. Patients with total hip arthroplasty will be followed up for 8-12 weeks, whereas patients with total knee arthroplasty will be followed up for 6-8 weeks. The primary outcome is health-related quality of life, measured by the EuroQol EQ-5D-5L scale. Secondary outcomes include functional recovery, pain, patient experience, and self-efficacy. The first results are expected to be submitted for publication in 2020.

IMPACT

This study will provide information on the health effects and cost benefits of using the DPJ solution to support a patient's preparation for surgery and postdischarge surgical care. If the DPJ solution is found to be effective, its implementation into clinical practice could lead to further improvements in patient outcomes. If the DPJ solution is found to be cost effective for the hospital, it could be used to improve hospital resource efficiency.

摘要

目的

描述一项随机对照试验(RCT)方案,该方案将评估数字患者旅程(DPJ)解决方案在改善全髋关节和膝关节置换术患者结局方面的有效性。

背景

迫切需要新技术来确保可持续性,改善患者体验,并通过提供信息、支持和控制来增强患者的自我护理能力。

设计

一项具有两个平行臂的实用 RCT。

方法

随机分配到干预组的参与者(N=33)将获得 DPJ 解决方案的访问权限。对照组(N=33)的参与者将接受传统护理,即通过使用纸质方法面对面提供。在招募和基线测量期间,以及在结局评估者中,将对研究护士进行分组分配进行盲法处理。全髋关节置换术患者将随访 8-12 周,而全膝关节置换术患者将随访 6-8 周。主要结局是健康相关生活质量,采用欧洲五维健康量表(EQ-5D-5L)进行测量。次要结局包括功能恢复、疼痛、患者体验和自我效能。预计第一批结果将于 2020 年提交发表。

影响

本研究将提供有关使用 DPJ 解决方案支持患者手术准备和出院后手术护理的健康效果和成本效益的信息。如果 DPJ 解决方案被证明有效,将其实施到临床实践中可能会进一步改善患者结局。如果 DPJ 解决方案对医院具有成本效益,它可以用于提高医院资源效率。

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