Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/1717
Title: Patient activation intervention to facilitate participation in recovery after total knee replacement (MIME): a cluster randomised cross-over trial.
Authors: de Steiger, Richard
Other Authors: Reynolds, J
Redley, B
Livingston, P.M.
Hutchinson, A.F.
Botti, M
Keywords: Bedside Multimedia Intervention
MyStay
Clinician-Facilitated Multimedia
MIME
High-Quality Healthcare
Outcomes
Health Services Research
Information Technology
IT
Patient-Centred Care
Cluster Trials
Unmasked Cluster Randomisation
Cross-Over Trial
Simultaneous Process Evaluation
Statistical Analysis
Total Knee Replacement Surgery
Total Knee Replacement
TKR
Surgery
Numerical Rating Scale
NRS
American Pain Society Patient Outcome Questionnaire
APSOQ-R
Pain Management
Oxford Knee Score
OKS
Department of Surgery, Epworth Healthcare
Centre for Quality and Safety Research, Epworth Partnership, Deakin University, Geelong, Victoria, Australia.
Epworth HealthCare, Vic, Australia
Issue Date: Apr-2019
Publisher: 2019 BMJ Publishing Group Ltd & the Health Foundation
Citation: (2019). Patient activation intervention to facilitate participation in recovery after total knee replacement (MIME): a cluster randomised cross-over trial. BMJ Qual Saf, 28:782-792.
Abstract: Patient participation in care is a fundamental element of safe and high-quality healthcare with the potential to enhance health outcomes and improve patient satisfaction. To test the efficacy of a clinician-facilitated, bedside multimedia (MyStay) intervention designed to support patient participation in their recovery after total knee replacement surgery. The primary outcome was patients' reported worst pain intensity on postoperative day 3. Secondary outcomes were patient activation, length of hospital stay, knee function and satisfaction with care. Unmasked, cluster randomised, four-period cross-over trial with a simultaneous process evaluation within in a large private, not-for-profit, metropolitan teaching hospital. Statistical analyses used linear mixed models with random effects for wards, cohorts within wards and patients within cohorts and fixed effects for treatment and period. 241 patients were recruited between March 2014 and June 2015. Patients were admitted to intervention (104) or control (137) clusters. Intervention group patients reported significantly lower mean pain intensity scores on postoperative day 3 (6.1 vs 7.1, 95% CI -1.94 to -0.08, p=0.04). The percentages of patients who reported severe pain (score ≥7) were 43.7% and 64.2% in the intervention and control groups, respectively (χ2 9.89, p=0.002; generalised linear mixed model Wald test, p=0.05). Intervention group patients on average stayed in hospital one less day (5.3 vs 6.3, 95% CI 0.05 to 1.94, p=0.04), reported higher activation (45.1% vs 27.1% at level 4 activation) (p=0.04) and higher overall satisfaction with care (9.3 vs 8.6, 95% CI 1.09 to 0.219, p=0.01), and were more likely to refer family or friends to the health service (9.3 vs 8.7, 95% CI 1.07 to 0.13, p=0.02).
Description: Open Access Article
URI: http://hdl.handle.net/11434/1717
DOI: 10.1136/bmjqs-2018-008975
PubMed URL: https://www.ncbi.nlm.nih.gov/pubmed/30975730
ISSN: 2044-5423
Journal Title: BMJ Quality & Safety
Type: Journal Article
Affiliated Organisations: Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Safety Research, Deakin University, Geelong, Victoria, Australia
The University of Melbourne, Melbourne, Victoria, Australia
Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Safety Research, Epworth Partnership, Deakin University, Geelong, Victoria, Australia
Type of Clinical Study or Trial: Cluster Randomised Cross-Over Trial
Linear Mixed Models
Appears in Collections:Health Informatics
Musculoskeletal

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