Reducing patient–staff contact in fast-track total hip arthroplasty has no effect on patient-reported out-comes, but decreases satisfaction amongst patients with self-perceived complications: analysis of 211 patients

Jens Bæk Hansen, Jens Fyhn Lykke Sørensen, Eva Natalia Glassou, Morten Homilius, Torben Bæk Hansen

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Abstract

BACKGROUND AND PURPOSE:  Several studies have compared fast-track with conventional pathways for total hip arthroplasty (THA) patients, but none have compared different fast-track pathways. Due to COVID-19 restrictions, our department had to minimize patient-staff contact in the THA pathway. First, telephone consultations were implemented instead of an outpatient clinic visit and subsequently preoperative patient education was discontinued. This enabled us to compare patient-reported outcomes and satisfaction among 3 fast-track pathways. PATIENTS AND METHODS: We collected data from patients treated for hip osteoarthritis with THA at Gødstrup Hospital between 2018 and 2021. The patients had experienced 1 of 3 pathways and were interviewed via telephone between 2 and 6 months after discharge. We analyzed the influence of patient pathway on patient-reported pain and mobility level, self-perceived complications, and compliance using logistic regression. We then compared the pathway's effect on patient satisfaction both for the total sample and for the patients who experienced complications. RESULTS:  The amount of patient-staff contact in the patient pathway did not have any influence on patientreported outcomes or the probability of self-perceived complications. For the full sample, patient-staff contact had no statistically significant influence on patient satisfaction either, but for the subgroup of patients experiencing complications, the pathways with less patient-staff contact reduced satisfaction. Patient satisfaction was primarily related to pain and mobility outcomes. INTERPRETATION:  Our results indicate that reducing patient-staff contact in fast-track THA can be done without influencing mobility and pain outcomes, but the overall satisfaction among patients with self-perceived complications will be negatively affected.

Original languageEnglish
JournalActa Orthopaedica
Volume93
Pages (from-to)264-270
ISSN1745-3674
DOIs
Publication statusPublished - Jan 2022

Keywords

  • Arthroplasty, Replacement, Hip/methods
  • COVID-19/prevention & control
  • Humans
  • Pain Measurement
  • Pandemics
  • Patient Reported Outcome Measures
  • Patient Satisfaction
  • Postoperative Complications/psychology
  • SARS-CoV-2
  • Telemedicine/methods

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