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Cost-Effectiveness of Web-Based Follow Ups

Primary Purpose

Osteoarthritis in the Knee Joint, Osteoarthritis in the Hip Joint

Status
Completed
Phase
Not Applicable
Locations
Canada
Study Type
Interventional
Intervention
in-person
web-based
Sponsored by
University of Western Ontario, Canada
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional health services research trial for Osteoarthritis in the Knee Joint focused on measuring osteoarthritis, arthroplasty, web-based, electronic follow-up

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • patients who have had a primary total hip or total knee arthroplasty

Exclusion Criteria:

  • patients with osteolysis, or previous complications from their joint replacement

Sites / Locations

  • London Health Sciences Centre - University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

web-based

in-person

Arm Description

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 will attend their follow-up appointments in-person as per usual

Outcomes

Primary Outcome Measures

Cost-effectiveness

Secondary Outcome Measures

Harris Hip Score
Western Ontario and McMaster Osteoarthritis Index (WOMAC)
SF-12
Adverse events

Full Information

First Posted
March 1, 2010
Last Updated
February 6, 2013
Sponsor
University of Western Ontario, Canada
Collaborators
The Physicians' Services Incorporated Foundation
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1. Study Identification

Unique Protocol Identification Number
NCT01079572
Brief Title
Cost-Effectiveness of Web-Based Follow Ups
Official Title
Cost-Effectiveness of Web-Based Follow Up Following Total Joint Arthroplasty
Study Type
Interventional

2. Study Status

Record Verification Date
February 2013
Overall Recruitment Status
Completed
Study Start Date
February 2010 (undefined)
Primary Completion Date
March 2011 (Actual)
Study Completion Date
March 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Western Ontario, Canada
Collaborators
The Physicians' Services Incorporated Foundation

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis in the Knee Joint, Osteoarthritis in the Hip Joint
Keywords
osteoarthritis, arthroplasty, web-based, electronic follow-up

7. Study Design

Primary Purpose
Health Services Research
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
260 (Actual)

8. Arms, Groups, and Interventions

Arm Title
web-based
Arm Type
Experimental
Arm Description
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.
Arm Title
in-person
Arm Type
Active Comparator
Arm Description
Patients will attend their follow-up appointments in-person as per usual
Intervention Type
Other
Intervention Name(s)
in-person
Intervention Description
Follow-up appointments will be completed in-person as per usual
Intervention Type
Other
Intervention Name(s)
web-based
Intervention Description
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.
Primary Outcome Measure Information:
Title
Cost-effectiveness
Time Frame
one year
Secondary Outcome Measure Information:
Title
Harris Hip Score
Time Frame
one year
Title
Western Ontario and McMaster Osteoarthritis Index (WOMAC)
Time Frame
one year
Title
SF-12
Time Frame
one year
Title
Adverse events
Time Frame
one year

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: patients who have had a primary total hip or total knee arthroplasty Exclusion Criteria: patients with osteolysis, or previous complications from their joint replacement
Facility Information:
Facility Name
London Health Sciences Centre - University Hospital
City
London
State/Province
Ontario
ZIP/Postal Code
N6G 1H1
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
25410510
Citation
Marsh J, Hoch JS, Bryant D, MacDonald SJ, Naudie D, McCalden R, Howard J, Bourne R, McAuley J. Economic evaluation of web-based compared with in-person follow-up after total joint arthroplasty. J Bone Joint Surg Am. 2014 Nov 19;96(22):1910-6. doi: 10.2106/JBJS.M.01558.
Results Reference
derived
PubMed Identifier
24881023
Citation
Marsh JD, Bryant DM, MacDonald SJ, Naudie DD, McCalden RW, Howard JL, Bourne RB, McAuley JP. Feasibility, effectiveness and costs associated with a web-based follow-up assessment following total joint arthroplasty. J Arthroplasty. 2014 Sep;29(9):1723-8. doi: 10.1016/j.arth.2014.04.003. Epub 2014 Apr 13.
Results Reference
derived
PubMed Identifier
24562873
Citation
Marsh J, Bryant D, MacDonald SJ, Naudie D, Remtulla A, McCalden R, Howard J, Bourne R, McAuley J. Are patients satisfied with a web-based followup after total joint arthroplasty? Clin Orthop Relat Res. 2014 Jun;472(6):1972-81. doi: 10.1007/s11999-014-3514-0. Epub 2014 Feb 22.
Results Reference
derived

Learn more about this trial

Cost-Effectiveness of Web-Based Follow Ups

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