Effectiveness of the Transitional Care Model in Total Knee Arthroplasty Patients

NCT ID: NCT05525793

Last Updated: 2022-09-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-02-08

Study Completion Date

2021-11-11

Brief Summary

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The aim of this study was to determine the effectiveness of transitional care in patients with total knee arthroplasty on patients' functional status, perceived self-efficacy, and health care use. Based on the sampling inclusion criteria, we assigned the patients who would undergo knee arthroplasty to the control (n=35) and intervention (n=35) groups, via the block randomization method. The intervention group received transitional care, while the control group received usual care. Data were collected on post-intervention functional status, level of self-efficacy, and hospital visits outside of routine control.

Detailed Description

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This randomised control study was conducted 70 eligible partients with total knee arthroplasty in a public hospital orthopedic and traumatology service. Participants were randomly assigned to receive either the 6-week 'Transitional Care Model' program or usual care. Assessments of self-efficacy and functional status of patients were conducted at baseline, 2nd and 9th weeks after discharge. Time-dependent changes in patient outcomes were assessed by using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Arthritis Self-efficacy Scale (ASES) measurements tools. Assessments of hospital visits outside of routine control were conducted 2nd week, 6th week, 9th week, and 12th weeks after discharge. The functional status of the intervention group patients improved more than the control group according to WOMAC mean scores. Intervention group patients receiving transitional care had higher mean scores at the 2nd-week and 9th-week postoperatively in perceived self-efficacy . Besides, the rate of admission to the hospital in the intervention group was lower compared to the control group, and a significant difference was observed in the 6th-week follow-up.

Conditions

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Knee Osteoarthritis Pain Self Efficacy Health Care Utilization

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Transitional care

This group is the actual intervention group.

Group Type EXPERIMENTAL

Transitional care model

Intervention Type OTHER

The patients who were assigned to this group with the transitional care model, 6 weeks of counseling and intervention training provided continuity of care and a safe transition, and patients were encouraged about symptom management and a healthy lifestyle.

Usual care

This group is the routine treatment (control) valid in the clinical practice.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Transitional care model

The patients who were assigned to this group with the transitional care model, 6 weeks of counseling and intervention training provided continuity of care and a safe transition, and patients were encouraged about symptom management and a healthy lifestyle.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Having decided to undergo total knee arthroplasty for the first time due to osteoarthritis
* Volunteering to participate in the research, not having a psychological, physical, and mental disability that may prevent communication, not having any major chronic problems such as end-stage organ failure, kidney, neurological, cancer
* Being discharged to the home from a hospital
* Being able to speak Turkish
* Being available by phone
* Being aged 50 and over

Exclusion Criteria

* Unwillingness to continue the study
* Rehospitalization
* Exposure to a disease or trauma that would affect functional independence during the study
Minimum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hasan Kalyoncu University

OTHER

Sponsor Role lead

Responsible Party

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Ayla Güllü

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Betül Tosun, Assoc. Prof.

Role: STUDY_CHAIR

Hasan Kalyoncu Üniversitesi

Locations

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Mustafa Kemal Üniversitesi

Antakya, Hatay, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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An S, Li J, Xie W, Yin N, Li Y, Hu Y. Extracorporeal shockwave treatment in knee osteoarthritis: therapeutic effects and possible mechanism. Biosci Rep. 2020 Nov 27;40(11):BSR20200926. doi: 10.1042/BSR20200926.

Reference Type BACKGROUND
PMID: 33074309 (View on PubMed)

Gaffney CJ, Pelt CE, Gililland JM, Peters CL. Perioperative Pain Management in Hip and Knee Arthroplasty. Orthop Clin North Am. 2017 Oct;48(4):407-419. doi: 10.1016/j.ocl.2017.05.001. Epub 2017 Jun 29.

Reference Type BACKGROUND
PMID: 28870302 (View on PubMed)

Magan AA, Ahmed SS, Paton B, Konan S, Haddad FS. Does Multimodal Therapy Influence Functional Outcome After Total Knee Arthroplasty? Orthop Clin North Am. 2020 Oct;51(4):453-459. doi: 10.1016/j.ocl.2020.06.011.

Reference Type BACKGROUND
PMID: 32950214 (View on PubMed)

Hanusch BC, O'Connor DB, Ions P, Scott A, Gregg PJ. Effects of psychological distress and perceptions of illness on recovery from total knee replacement. Bone Joint J. 2014 Feb;96-B(2):210-6. doi: 10.1302/0301-620X.96B2.31136.

Reference Type BACKGROUND
PMID: 24493186 (View on PubMed)

Mardani A, Griffiths P, Vaismoradi M. The Role of the Nurse in the Management of Medicines During Transitional Care: A Systematic Review. J Multidiscip Healthc. 2020 Oct 30;13:1347-1361. doi: 10.2147/JMDH.S276061. eCollection 2020.

Reference Type BACKGROUND
PMID: 33154651 (View on PubMed)

Allen J, Hutchinson AM, Brown R, Livingston PM. Communication and Coordination Processes Supporting Integrated Transitional Care: Australian Healthcare Practitioners' Perspectives. Int J Integr Care. 2020 Apr 16;20(2):1. doi: 10.5334/ijic.4685.

Reference Type BACKGROUND
PMID: 32322183 (View on PubMed)

Morkisch N, Upegui-Arango LD, Cardona MI, van den Heuvel D, Rimmele M, Sieber CC, Freiberger E. Components of the transitional care model (TCM) to reduce readmission in geriatric patients: a systematic review. BMC Geriatr. 2020 Sep 11;20(1):345. doi: 10.1186/s12877-020-01747-w.

Reference Type RESULT
PMID: 32917145 (View on PubMed)

Hung D, Leidig RC. Implementing a transitional care program to reduce hospital readmissions among older adults. J Nurs Care Qual. 2015 Apr-Jun;30(2):121-9. doi: 10.1097/NCQ.0000000000000091.

Reference Type RESULT
PMID: 25485791 (View on PubMed)

Costa MFBNAD, Sichieri K, Poveda VB, Baptista CMC, Aguado PC. Transitional care from hospital to home for older people: implementation of best practices. Rev Bras Enferm. 2020 Nov 2;73Suppl 3(Suppl 3):e20200187. doi: 10.1590/0034-7167-2020-0187. eCollection 2020. English, Portuguese.

Reference Type RESULT
PMID: 33146267 (View on PubMed)

Lyu QY, Huang JW, Li YX, Chen QL, Yu XX, Wang JL, Yang QH. Effects of a nurse led web-based transitional care program on the glycemic control and quality of life post hospital discharge in patients with type 2 diabetes: A randomized controlled trial. Int J Nurs Stud. 2021 Jul;119:103929. doi: 10.1016/j.ijnurstu.2021.103929. Epub 2021 Mar 26.

Reference Type RESULT
PMID: 33901941 (View on PubMed)

Liu ZC, Gao L, Zhang WH, Wang J, Liu RR, Cao BH. Effects of a 4-week Omaha System transitional care programme on rheumatoid arthritis patients' self-efficacy, health status, and readmission in mainland China: A randomized controlled trial. Int J Nurs Pract. 2020 Aug;26(4):e12817. doi: 10.1111/ijn.12817. Epub 2020 Jan 27.

Reference Type RESULT
PMID: 31985129 (View on PubMed)

Kranker K, Barterian LM, Sarwar R, Peterson GG, Gilman B, Blue L, Stewart KA, Hoag SD, Day TJ, Moreno L. Rural hospital transitional care program reduces Medicare spending. Am J Manag Care. 2018 May;24(5):256-260.

Reference Type RESULT
PMID: 29851443 (View on PubMed)

Nall RW, Herndon BB, Mramba LK, Vogel-Anderson K, Hagen MG. An Interprofessional Primary Care-Based Transition of Care Clinic to Reduce Hospital Readmission. Am J Med. 2020 Jun;133(6):e260-e268. doi: 10.1016/j.amjmed.2019.10.040. Epub 2019 Dec 24.

Reference Type RESULT
PMID: 31877267 (View on PubMed)

Other Identifiers

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2021/004

Identifier Type: OTHER

Identifier Source: secondary_id

Hasan Kalyoncu Üniversitesi

Identifier Type: -

Identifier Source: org_study_id

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