Clinical trial NCT01079572: Cost-Effectiveness of Web-Based Follow Ups
Official title: Cost-Effectiveness of Web-Based Follow Up Following Total Joint Arthroplasty
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Osteoarthritis in the Knee Joint
Osteoarthritis in the Hip Joint
Keywords: osteoarthritis
arthroplasty
web-based
electronic follow-up
Lead sponsor: University of Western Ontario, Canada
Sponsor class: OTHER
Collaborators: name: The Physicians' Services Incorporated Foundation
First posted: 2010-03-03
Enrollment: 260
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

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.


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

Primary outcomes:
measure: Cost-effectiveness
timeFrame: one year
Secondary outcomes:
measure: Harris Hip Score
timeFrame: one year
measure: Western Ontario and McMaster Osteoarthritis Index (WOMAC)
timeFrame: one year
measure: SF-12
timeFrame: one year
measure: Adverse events
timeFrame: one year
Other outcomes:
Locations:
city: London
country: Canada
facility: London Health Sciences Centre - University Hospital
state: Ontario
Study officials:
References:
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.
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.
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.