Improving outcomes with ACT after knee surgery (IMPACTS)

  • Research type

    Research Study

  • Full title

    Acceptability and Feasibility of Acceptance and Commitment Therapy in Total Knee Arthroplasty Patients

  • IRAS ID

    303136

  • Contact name

    Richard Napier

  • Contact email

    Richard.Napier@belfasttrust.hscni.net

  • Sponsor organisation

    Belfast HSC Trust

  • Duration of Study in the UK

    1 years, 9 months, 30 days

  • Research summary

    Regarding psychosocial factors and outcomes in total knee arthroplasty (TKA), most of the current literature and our previous work suggests that depression, anxiety and pre-operative pain strongly predict worse outcomes following TKA. Despite some conflicting evidence, on the whole, the current literature suggests that psychological intervention in TKA patients could help to improve outcomes. In recent years, Acceptance and Commitment Therapy (ACT) has been receiving more attention as it may be more effective than the more traditional cognitive behavioural therapy in treating older people with chronic pain. ACT includes a combination of acceptance and mindfulness methods along with activation and behaviour change methods.

    There have been several studies examining ACT in patients undergoing orthopaedic surgery. These studies have found that attending a pre-operative ACT workshop and receiving text messages reinforcing ACT can reduce use of pain medication, reduce post-operative pain and improve function following surgery. There are also two study protocols published which plan to investigate ACT in TKA patients but the findings of these studies are yet to be reported.

    In this feasibility study, we propose to investigate the acceptability and feasibility of a pre-operative ACT workshop in TKA patients considered to be at risk of poorer outcome based on a depression score. If found to be acceptable and feasible to both patients and those who will deliver the ACT sessions, a larger study will be performed.

  • REC name

    HSC REC B

  • REC reference

    23/NI/0149

  • Date of REC Opinion

    21 Nov 2023

  • REC opinion

    Favourable Opinion