Health coaching for patients waiting for hip or knee replacements
Research type
Research Study
Full title
Feasibility of Targeted Health Coaching for Patients with Low Activation Waiting for Total Hip or Total Knee Replacements
IRAS ID
326466
Contact name
Tom Maden-Wilkinson
Contact email
Sponsor organisation
Sheffield Hallam University
Duration of Study in the UK
0 years, 4 months, 28 days
Research summary
Research Summary
There is an urgent need to actively engage with patients to prevent physical and cognitive deterioration in patients waiting for elective hip and knee arthroplasty in Sheffield. In Sheffield, more than 800 people are currently waiting for surgery related to Osteoarthritis of the Hip and Knee, with more than 250 people waiting for more than a year.
Surgery performed later in the natural history of disease is shown to have significant impact on pain, function, and health-related quality of life at the time of surgery. Prospective studies have linked preoperative functional limitations to worse postoperative patient-reported outcomes. If patients face an extended wait for surgery they will deteriorate, and rehabilitation outcomes will worsen. Additional input is required during the wait period to reduce risk of deterioration to health and wellbeing. There is a compelling rationale for exercise interventions before surgery, both aerobic exercise which is associated with anaesthetic risk and surgical outcome, but also strength and balance exercise to reduce deconditioning and improve functional rehabilitation outcomes.
Supported self-management involves ensuring that people with long-term conditions have the knowledge, skills, confidence and support they need to manage their condition(s) effectively in the context of their everyday life. If patients face an extended wait for surgery they will deteriorate, and rehabilitation outcomes will worsen. Additional input is required during the wait period to reduce risk of deterioration to health and wellbeing. Any additional support put in place to help people to self-manage over the wait period must be optimised from an equity perspective. Where factors such as health literacy, self-efficacy and activation are low, more support is required to enable people to successfully self-manage. Self-management programmes therefore need to be stratified to meet people’s needs, with higher intensity programmes available to meet the needs of people who have the greatest propensity for deterioration. The proposed study aims to evaluate the feasibility of a targeted health coaching intervention for people on the waitlist for hip or knee replacement surgery requiring a higher level of support for self-management.
Lay Summary
1. Recruitment and Participation: High recruitment and eligibility rates were observed, a no participants were lots at allocation. No adverse events were recorded during this study.
2. Health Coaching Engagement: Among those in the health coaching group, most attended at least one session, with an average of four sessions per participant. Most of these sessions took place over the phone. Few participants withdrew from the trial, citing reasons such as scheduling conflicts or lack of time.
3. Intervention Experience: Participants in the health coaching group reported high levels of enjoyment, benefit, overall satisfaction, quality of information, amount of information and ease of use
4. Patient-Reported Outcomes: The study measured changes in pain, sleep quality, fatigue, and overall hip/knee health. Baseline and follow-up data suggest that there were no changes.
5. Quality of Life Assessment: Using a questionnaire, the study assessed changes in quality of life in areas like mobility, self-care, and mental well-being. No improvements were observed.
6. Patient Activation Measure: The study also looked at how engaged and active participants were in managing their health before and after the trial. The results showed an improved patient activation following health coaching.
Overall, the study suggests that health coaching can have a positive impact on patients' satisfaction and their engagement in health management, though the effects on clinical outcomes such as pain and quality of life are less clear.REC name
London - West London & GTAC Research Ethics Committee
REC reference
23/PR/0638
Date of REC Opinion
14 Jul 2023
REC opinion
Further Information Favourable Opinion