None listed
Conditions
Brief summary
Following elective total hip or knee replacement surgery (THR/TKR), receiving care at home instead of hospital is recommended for most patients. However, care at home services such as rehabilitation-at-home are underutilised in private hospitals. Research suggests the primary reason patients spend additional time in private hospitals is driven by patient concerns with safety and value of care at home. To address patient concerns, we have designed new patient information aiming to dispel fears about safety and better inform patients about the benefits of rehabilitation-at-home. The primary aim of our trial is to investigate if new patient information helps more patients to receive rehabilitation-at-home instead of hospital. For patients scheduled for a THR or TKR at a private hospital, we will randomly select 299 patients to receive new patient information before surgery, and another 299 patients who will receive the current information only. Then we can compare the two groups to see if the new information help more patients receive rehabilitation-at-home. We will also measure patient outcomes (e.g., quality of life) and costs between the two groups. We also plan to compare outcomes between participants who receive non-inpatient rehabilitation (i.e., rehabilitation-at-home or outpatient rehabilitation) versus inpatient rehabilitation care. Alongside the trial, we will also conduct interviews with a subset of participants who received the new patient information, to explore their perspectives on the intervention based on their experiences.
Interventions
Materials: A one page patient information 'nudge letter' (plus usual care) will be provided to participants
Content: The letter, designed specifically for this study, will contain behavioural change techniques of persuasive argument and shaping knowledge. The letter will contain lay language about the positive consequences of rehabilitation-at-home, statements that allay fears of home safety and burdening their caregiver, assurances about capability and confidence at home, and information from
Materials: A one page patient information 'nudge letter' (plus usual care) will be provided to participants Content: The letter, designed specifically for this study, will contain behavioural change techniques of persuasive argument and shaping knowledge. The letter will contain lay language about the positive consequences of rehabilitation-at-home, statements that allay fears of home safety and burdening their caregiver, assurances about capability and confidence at home, and information from trusted source. The letter is personalised to individuals by including their specific surgery type (hip or knee replacement) and orthopaedic surgeon's name. Mode of delivery and process: a research assistant will distribute the letter to participants individually via both mail and email, once prior to surgery. Strategies used to monitor adherence to/fidelity of the intervention, will include email read receipts and a follow-up email or telephone call.
Sponsors
Jason Wallis
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
-Adults scheduled for elective, primary total hip or knee replacement surgery (THR or TKR) at the private hospital's two acute care sites -Living independently in the community -A Risk Assessment and Prediction Tool (RAPT) score of 6 to 9. This score range (6 to 9) predicts home discharge with additional intervention (e.g., rehabilitation-at-home).
Exclusion criteria
Patients admitted via the emergency department indicating a non-elective procedure will be excluded.
Outcome results
None listed