The use of digitally collected patient-reported outcome measures for newly operated patients with total knee and hip replacements to improve post-treatment recovery: study protocol for a randomized controlled trial

dc.contributor.authorKuklinski, David
dc.contributor.authorOschmann, Laura
dc.contributor.authorPross, Christoph
dc.contributor.authorBusse, Reinhard
dc.contributor.authorGeissler, Alexander
dc.date.accessioned2020-11-30T12:19:34Z
dc.date.available2020-11-30T12:19:34Z
dc.date.issued2020-04-09
dc.description.abstractBackground The number of total knee replacements (TKRs) and total hip replacements (THRs) has been increasing noticeably in high-income countries, such as Germany. In particular, the number of revisions is expected to rise because of higher life expectancy and procedures performed on younger patients, impacting the budgets of health-care systems. Quality transparency is the basis of holistic patient pathway optimization. Nevertheless, a nation-wide cross-sectoral assessment of quality from a patient perspective does not yet exist. Several studies have shown that the use of patient-reported outcome measures (PROMs) is effective for measuring quality and monitoring post-treatment recovery. For the first time in Germany, we test whether early detection of critical recovery paths using PROMs after TKR/THR improves the quality of care in a cost-effective way and can be recommended for implementation into standard care. Methods/design The study is a two-arm multi-center patient-level randomized controlled trial. Patients from nine hospitals are included in the study. Patient-centered questionnaires are employed to regularly measure digitized PROMs of TKR/THR patients from the time of hospital admission until 12 months post-discharge. An expert consortium has defined PROM alert thresholds at 1, 3, and 6 months to signal critical recovery paths after TKR/THR. An algorithm alerts study assistants if patients are not recovering in line with expected recovery paths. The study assistants contact patients and their physicians to investigate and, if needed, adjust the post-treatment protocol. When sickness funds’ claims data are added, the cost-effectiveness of the intervention can be analyzed. Discussion The study is expected to deliver an important contribution to test PROMs as an intervention tool and examine the determinants of high-quality endoprosthetic care. Depending on a positive and cost-effective impact, the goal is to transfer the study design into standard care. During the trial design phase, several insights have been discovered, and there were opportunities for efficient digital monitoring limited by existing legacy care models. Digitalization in hospital processes and the implementation of digital tools still represent challenges for hospital personnel and patients. Furthermore, data privacy regulations and the separation between the in- and outpatient sector are roadblocks to effectively monitor and assess quality along the full patient pathway.en
dc.description.sponsorshipTU Berlin, Open-Access-Mittel – 2020en
dc.identifier.eissn1745-6215
dc.identifier.issn1468-6708
dc.identifier.urihttps://depositonce.tu-berlin.de/handle/11303/12081
dc.identifier.urihttp://dx.doi.org/10.14279/depositonce-10956
dc.language.isoenen
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subject.ddc610 Medizin und Gesundheitde
dc.subject.otherhealth-care policyen
dc.subject.otherPROMen
dc.subject.otherquality of careen
dc.subject.otherTKRen
dc.subject.otherTHRen
dc.subject.othervalue-based health careen
dc.subject.otherrandomized controlled trialen
dc.titleThe use of digitally collected patient-reported outcome measures for newly operated patients with total knee and hip replacements to improve post-treatment recovery: study protocol for a randomized controlled trialen
dc.typeArticleen
dc.type.versionpublishedVersionen
dcterms.bibliographicCitation.articlenumber322en
dcterms.bibliographicCitation.doi10.1186/s13063-020-04252-yen
dcterms.bibliographicCitation.journaltitleTrialsen
dcterms.bibliographicCitation.originalpublishernameBioMed Centralen
dcterms.bibliographicCitation.originalpublisherplaceLondonen
dcterms.bibliographicCitation.volume21en
tub.accessrights.dnbfreeen
tub.affiliationFak. 7 Wirtschaft und Management::Inst. Technologie und Management (ITM)::FG Management im Gesundheitswesende
tub.affiliation.facultyFak. 7 Wirtschaft und Managementde
tub.affiliation.groupFG Management im Gesundheitswesende
tub.affiliation.instituteInst. Technologie und Management (ITM)de
tub.publisher.universityorinstitutionTechnische Universität Berlinen

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