Do Patient Engagement Platforms in Total Joint Arthroplasty Improve Patient-Reported Outcomes?

joint-specific outcomes patient engagement portals patient-reported outcomes total hip arthroplasty total joint arthroplasty total knee arthroplasty

Journal

The Journal of arthroplasty
ISSN: 1532-8406
Titre abrégé: J Arthroplasty
Pays: United States
ID NLM: 8703515

Informations de publication

Date de publication:
12 2021
Historique:
received: 04 05 2021
revised: 16 06 2021
accepted: 02 08 2021
pubmed: 6 9 2021
medline: 25 12 2021
entrez: 5 9 2021
Statut: ppublish

Résumé

Web-based patient engagement portals are increasing in popularity after total hip and knee arthroplasty (THA and TKA). The literature is mixed regarding patient utilization of these modalities and potential clinical benefit. We sought to determine which demographic factors are associated with increased platform participation and to quantify the impact of a web-based patient portal on patient-reported outcome measures (PROMs). We performed a retrospective analysis of consecutive primary THA (n = 554) and TKA (n = 485) at a single academic institution with minimum follow-up of 12 months. Patients were divided into those who opted-in and those who opted-out of portal use. Global health and joint-specific PROMs were collected preoperatively and postoperatively. Linear mixed effects modeling, bivariate analysis, and logistic regression were utilized. Of the 1039 included patients, 60.6% (336) THA and 62.7% (304) TKA patients enrolled in the portal. Those who opted-in were younger (P < .001, P < .003), had higher body mass index (P = .024, P = .011), and had a higher household income (P < .001, P < .001) in THA and TKA cohorts, respectively. Portal participation in the TKA but not the THA cohort was associated with significant improvement in physical function (P = .017) and joint-specific function (P = .045). For THA patients who opted-in, increased portal logins were associated with more rapid improvement and higher functional scores (P = .013). There is an inherent difference between patients who opt-in to and those who opt-out of web-based portals. Added resources and support provided by portals may translate to improved PROMs for TKA patients but not THA patients.

Sections du résumé

BACKGROUND
Web-based patient engagement portals are increasing in popularity after total hip and knee arthroplasty (THA and TKA). The literature is mixed regarding patient utilization of these modalities and potential clinical benefit. We sought to determine which demographic factors are associated with increased platform participation and to quantify the impact of a web-based patient portal on patient-reported outcome measures (PROMs).
METHODS
We performed a retrospective analysis of consecutive primary THA (n = 554) and TKA (n = 485) at a single academic institution with minimum follow-up of 12 months. Patients were divided into those who opted-in and those who opted-out of portal use. Global health and joint-specific PROMs were collected preoperatively and postoperatively. Linear mixed effects modeling, bivariate analysis, and logistic regression were utilized.
RESULTS
Of the 1039 included patients, 60.6% (336) THA and 62.7% (304) TKA patients enrolled in the portal. Those who opted-in were younger (P < .001, P < .003), had higher body mass index (P = .024, P = .011), and had a higher household income (P < .001, P < .001) in THA and TKA cohorts, respectively. Portal participation in the TKA but not the THA cohort was associated with significant improvement in physical function (P = .017) and joint-specific function (P = .045). For THA patients who opted-in, increased portal logins were associated with more rapid improvement and higher functional scores (P = .013).
CONCLUSION
There is an inherent difference between patients who opt-in to and those who opt-out of web-based portals. Added resources and support provided by portals may translate to improved PROMs for TKA patients but not THA patients.

Identifiants

pubmed: 34481693
pii: S0883-5403(21)00643-4
doi: 10.1016/j.arth.2021.08.003
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3850-3858

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Auteurs

Andrew J Holte (AJ)

Department of Orthopedics, Dartmouth-Hitchcock Medical Center, One Medical Center Dr., Lebanon, NH.

Ilda B Molloy (IB)

Department of Orthopedics, Dartmouth-Hitchcock Medical Center, One Medical Center Dr., Lebanon, NH.

Paul M Werth (PM)

Department of Orthopedics, Dartmouth-Hitchcock Medical Center, One Medical Center Dr., Lebanon, NH.

David S Jevsevar (DS)

Department of Orthopedics, Dartmouth-Hitchcock Medical Center, One Medical Center Dr., Lebanon, NH.

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