Knee Replacement Rehabilitation Care Pathways

Официальное название

Development and Implementation of Optimal Rehabilitation Care Pathways to Reduce Disparities in Rehabilitation Outcomes After Joint Replacement

Обзор

Previous research has shown that use of rehabilitation (including physical therapy) and the recovery of function after knee replacement surgery may differ depending on patients' race, sex, income or insurance, and geographic location. In this study, the investigators will develop and test a new care pathway for knee replacement rehabilitation that is designed to maximize functional recovery for all patients and reduce differences between different groups of patients. Findings from this project will lead to improved rehabilitation quality after knee replacement surgery.

Подробное описание

In previous work, the investigators used quantitative and qualitative data to identify sociodemographic disparities in physical function and use of rehabilitation following total knee arthroplasty (TKA), or knee replacement surgery. The investigators also identified patient and provider impressions regarding areas of the post-TKA rehabilitation pathway and recommendations for improvements. Based on all of this information, the investigative team has developed a newly-optimized rehabilitation care pathway and will pilot test this approach in this study.

Вмешательства

• Поведенческое TKA Journey - patient education
  The investigators' team developed a new patient education booklet containing information that walks the patient through their TKA journey, from pre-operative to hospital-based rehabilitation prior to discharge, to outpatient physical therapy, and after discharge from formal physical therapy services. All patients in the intervention arm will receive this booklet from their surgeon's office and will receive a phone call from study personnel to review it and answer any questions.
• Другое Optimized Rehab Scheduling
  For all patients in the 'intervention' practice, the home health referral will include instructions for the home health physical therapist to assist the patient with scheduling their first outpatient physical therapy session, to avoid unnecessary gaps in care between home health discharge and outpatient physical therapy evaluation.
• Поведенческое Usual Rehab
  Participants in the usual rehab group will continue to follow the current standard-of-care rehabilitation pathway for patients post-TKA.

Первичные конечные точки

• Patient Satisfaction [Срок оценки: 3 months post-TKA surgery]

Вторичные конечные точки (3)

• Rehab timing [Срок оценки: For most patients, this will occur approximately 2 weeks post-operatively.]
• Completion of in-depth, semi-structured focus group interviews (study participants) [Срок оценки: 3 months post-operatively]
• Completion of in-depth, semi-structured 1-on-1 interviews (physical therapists who treat patients post-total knee arthroplasty) [Срок оценки: 4 months after enrollment of the first participant in the study]

Критерии участия

Критерии включения

• scheduled to receive unilateral TKA surgery at a University of Pittsburgh Medical Center hospital
• plans to utilize UPMC Home Health and/or UPMC Rehab Institute for home health and/or outpatient rehabilitation post-operatively

Критерии исключения

• does not undergo planned surgery
• does not receive any post-TKA rehabilitation at UPMC facilities

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Нерандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Организация здравоохранения

Центры проведения

США · 1 центр

• University of Pittsburgh — Pittsburgh

Идентификаторы

NCT: NCT07598539 · K23MD018640 · K23MD018640

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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