Automated Hovering for Joint Replacement Surgery
Condition: Joint Disease
MeSH terms: Joint Diseases
Study type: Interventional

Summary: 
      This will evaluate the effectiveness of automated hovering to encourage patients to be
      discharged to home after hip or knee replacement surgery. Automated hovering includes
      monitoring of physical activity with an activity monitor, tracking of pain scores, daily
      feedback and motivational messages, social influence, and connection to clinicians as needed.
    

Detailed description: 
      The goal of this study is to test the approach of automated hovering to encourage patients to
      be discharged to home safely after lower extremity joint replacement surgery (LEJR). The
      investigators will target those patients undergoing hip or knee replacement surgery at a
      large urban hospital system at two different sites. The investigators aim is to increase the
      number of patients that are discharged to home, by providing patients with a physical
      activity pedometer, daily pain score tracking through bi-directional text messaging,
      milestone and nudge messaging for recovery, social influence, and connection to clinicians as
      needed for 6 weeks after surgery. Eligible participants are age 18-85, with a Risk Assessment
      and Prediction Tool (RAPT) score of 6-8 and are scheduled to undergo lower-extremity joint
      replacement surgery. Participants will be randomized 1:1 to usual care (Arm 1) and
      intervention (Arms 2a and 2b). After enrollment with the monitoring device, participants in
      the intervention group will be randomized 1:1 to Arm 2a (remote monitoring) or Arm 2b (remote
      monitoring + goal-setting and social support). Both intervention arms will receive the
      intervention for 6 weeks post-surgery.
    

Intervention name(s): Remote monitoring; Remote monitoring plus goal setting and social support
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Patients given an activity tracker to wear for 6 weeks after LEJR replacement surgery. For 2 weeks after surgery, they will also receive a daily text messages asking what their pain is on a scale of 0 to 10. They will be asked to reply to the text with their pain score. They will also be sent occasional messaging about their recovery, tips of what to do, and feedback on their progress. They will also also be sent a text message if they stop using their activity tracker for 3 days.; Patients given activity tracker to wear for 6 weeks after LEJR surgery. For 2 weeks after surgery, they will receive a daily text messages asking what their pain is on a scale of 0 to 10 and asked to reply by text. They will be sent occasional messaging about their recovery, tips of what to do, and feedback on their progress. They will also also be sent a text message if they stop using their activity tracker for 3 days. Patients will be asked to identify a a friend or family member to act as support partner. The study will share progress updates with support partner and contact this individual if patient stops wearing the activity tracker for over 3 days. This partner will also be able to provide supportive messages to help encourage them to reach their activity goals.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Health Services Research