Short-term effects of a digital patient journey solution on patient-reported outcomes and health care utilization in arthroplasty: a pragmatic randomized controlled trial

Authors

• Miia Jansson Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland; Oulu University Hospital, Oulu, Finland
• Hilkka Liedes VTT Technical Research Centre of Finland Ltd, Oulu, Finland
• Anna-Leena Vuorinen VTT Technical Research Centre of Finland Ltd, Tampere, Finland
• Marja Harjumaa Oulu University Hospital, Oulu, Finland; VTT Technical Research Centre of Finland Ltd, Oulu, Finland
• Heidi Similä VTT Technical Research Centre of Finland Ltd, Oulu, Finland
• Jonna Koivisto Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
• Ari-Pekka Puhto OYS Centre for Musculoskeletal Surgery, Oulu University Hospital, Oulu, Finland
• Gillian Vesty School of Accounting, RMIT University, Melbourne, Australia
• Hong-Gu He Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
• Minna Pikkarainen Department for Rehabilitation Science and Health Technology & Department of Product Design, Oslomet, Oslo Metropolitan University, Norway; Martti Ahtisaari Institute, University of Oulu, Finland

DOI: https://doi.org/10.23996/fjhw.124750

Keywords:

clinical trial, patient reported outcome measures, randomized controlled trial, telemedicine

Abstract

Mobile health solutions for patient support have been proposed as promising and safe alternatives to usual care in adults undergoing primary total hip and knee arthroplasty. Studies of such applications, however, have produced conflicting results and only moderate- to low-quality evidence.

This study aims to evaluate the short-term effects of a digital patient journey solution on patient-reported outcomes and health care utilization in patients undergoing total hip and knee arthroplasty using a pragmatic randomized controlled trial design. Randomly allocated patients in the control arm (n = 35, 64 ± 9 years) received usual care, while patients in the intervention arm (n = 34, 62 ± 11 years) received the digital patient journey solution in addition to usual care.

The primary outcome was health-related quality of life as measured by the EuroQol EQ-5D-5L scale. Secondary outcomes included functional recovery, pain, self-efficacy, patient experience, adherence to fast-track protocol, and health care utilization. Participants were followed from a preoperative surgical visit until a postoperative follow-up visit at 6–12 weeks.

The health-related quality of life, functional recovery, pain, patient experience, adherence to the fast-track protocol, and health care utilization did not differ between the arms. During the study, however, the self-efficacy to use digital health services (p=0.027) increased in the intervention arm.

The use of the digital patient journey solution was not superior to usual care in terms of patient-reported outcomes and health care utilization. However, the solution improved the self-efficacy of patients to use digital health services, which may lead to greater demand for similar digital offerings as patient become more familiar with mobile health solutions.