Clinical trial NCT06647719: Postoperative Care After Carpal Tunnel Release Using Short Educational Videos
Official title: Patient Directed Care After Carpal Tunnel Release Using Video Integration and Digital Education After Operations (VIDEO)
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Carpal Tunnel Syndrome
Patient Satisfaction
Keywords: Carpal tunnel release (CTR)
Patient-directed care
Educational videos
Minor hand surgery
Lead sponsor: Carilion Clinic
Sponsor class: OTHER
Collaborators: name: Virginia Tech Carilion School of Medicine and Research Institute
First posted: 2024-10-18
Enrollment: 84
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The goal of this clinical trial is to learn if a patient-directed postoperative care program, using short educational videos, can improve patient satisfaction and reduce healthcare resource utilization in patients undergoing carpal tunnel release (CTR). The main questions it aims to answer are:

Will patients in the video-based care program be more satisfied with their postoperative care? Will this approach reduce healthcare resource use and the burden on patients without increasing complication rates? Researchers will compare the video-based patient-directed care group to the standard in-person follow-up group to see if patient satisfaction and resource use differ while maintaining similar outcomes and complication rates.

Participants will:

Watch three short educational videos (\< 60 seconds each) on postoperative care. Schedule a suture removal appointment with a nurse at their convenience if needed.

Continue to have access to their provider through traditional methods such as phone, EMR, or urgent in-person visits.

Detailed description: Carpal tunnel release (CTR) is a commonly performed procedure with predictable outcomes and a low complication rate. Traditionally, patients are scheduled for two postoperative follow-up visits-one at two weeks and another at six weeks. However, these routine visits rarely lead to a change in patient management and often impose logistical and financial burdens on patients, particularly for those living in rural areas who must travel long distances to their healthcare provider's clinic.

This study proposes an alternative postoperative care model for CTR patients that leverages short educational videos and allows patients to manage their recovery more independently. The experimental group in the study will receive three brief (\< 60 seconds each) educational videos after surgery. These videos will cover key aspects of postoperative care, including wound management and when to seek medical attention. Unlike the traditional model, patients in this group will not have scheduled in-person or virtual follow-up visits unless they require them. All patients in the experimental group will still have access to their healthcare provider through standard communication channels, such as:

Calling the office for advice or concerns. Sending secure messages through the electronic medical record (EMR) system. Attending urgent in-person visits if necessary. If nonabsorbable sutures are used during surgery, patients in the experimental group will schedule an appointment for suture removal with a nurse at their convenience, usually 10-14 days post-surgery.

The primary goal of the study is to determine whether this patient-directed care model, which utilizes educational videos, can improve patient satisfaction and reduce the use of healthcare resources without compromising care quality or increasing complication rates.

Specific Aim: The study aims to evaluate whether a patient-directed postoperative care program for CTR can:

Improve patient satisfaction. Reduce healthcare resource utilization. Lessen the burden of care (e.g., fewer missed workdays and less time spent on healthcare-related activities).

Maintain comparable patient-reported outcomes, complication rates, and the number of urgent visits as those observed in traditional in-person follow-up care.

Hypotheses:

Patients who receive the educational videos will report higher satisfaction with their care.

These patients will miss fewer days of work and spend less time on health-related activities.

The experimental group will consume fewer healthcare resources (e.g., fewer clinic visits).

Patient-reported outcomes, complication rates, and urgent visits will be similar between the experimental and standard in-person care groups.

Significance: The results of this study have the potential to transform and enhance postoperative care for patients undergoing CTR and other minor surgical procedures. By reducing the need for routine in-person visits, the proposed care model can help alleviate the burden on patients, particularly those from rural areas. Additionally, reducing clinic utilization for straightforward postoperative cases could increase the availability of clinic appointments for more complex cases, thereby improving overall healthcare system efficiency. This patient-directed model could also be expanded to other surgical and nonsurgical conditions, empowering patients to take a more active role in their recovery while maintaining high standards of care.

Eligibility criteria: Inclusion Criteria:

* Patients undergoing either endoscopic (CPT 29848) or open CTR (CPT 64721)
* Access to a smartphone, tablet, or computer to view educational videos
* Access to internet to download or view postoperative education videos
* Age 18 or older

Exclusion Criteria:

* Patients undergoing any additional procedures
* Worker's compensation status
* Revision procedures
* Patients unable to utilize technology to view videos or follow instructions
* Patients with no access to internet
* Inability to provide informed consent for the study
* Patients unable to speak English fluently

Primary outcomes:
measure: Patient-Reported Outcome Measurement Information System (PROMIS) / Upper Extremity Computer Adaptive Test (UE CAT) / 5-Point Likert Scale
timeFrame: 2 and 6 weeks postoperatively
Secondary outcomes:
measure: Time Taken Off Work
timeFrame: Baseline to 6 week follow up
measure: Travel time.
timeFrame: Baseline to 6 week follow up
measure: Number of Unplanned Visits
timeFrame: Baseline to 6 week follow up.
measure: Patient Satisfaction Questionnaire
timeFrame: Baseline to 6 week follow up.
measure: Wound Complications
timeFrame: Baseline to 6 week follow up.
measure: Total In Person Postoperative Visits
timeFrame: Baseline to 6 week follow up.
Other outcomes:
Locations:
city: Roanoke
country: United States
facility: Carilion Clinic Orthopaedic Surgery
state: Virginia
Study officials:
affiliation: Carilion Clinic
name: Cesar Bravo, M.D.
role: PRINCIPAL_INVESTIGATOR
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