Effectiveness of eHealth Tools for Hip and Knee Arthroplasty: A Systematic Review.
Somayyeh Mohammadi, William C Miller, Julia Wu and 2 others
PMID 36188859WHAT IT FOUND
Most comparisons showed eHealth tools after hip or knee replacement did not outperform usual care on physical or psychological outcomes, but several studies found lower travel, time, and cost.
Key findings
01In the physical outcomes, 169 comparisons showed no statistically significant difference and 28 showed significant differences, with 25 favoring eHealth.
02In psychological and social outcomes, 54 of 67 comparisons showed no significant difference or similar improvement in both groups; 12 comparisons were significant, including higher anxiety and pain-related catastrophizing in one educational video group.
03Cost-related outcomes were measured in seven studies; in 15 comparisons, eHealth groups reported lower expenses and costs than usual care groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review did not preselect a primary outcome. The included studies used many different eHealth tools, durations, and outcome measures, and the authors did not perform a meta-analysis. Eight studies either failed to blind personnel, and 11 did not provide enough information about blinding personnel. Incomplete outcome data and other sources of bias, such as not reporting funding sources, were also unmet criteria. Twenty-five of the included studies targeted total knee arthroplasty, and only one study used eHealth before surgery. Cost outcomes were measured in only seven studies. Qualitative studies and two non-English studies were excluded. No patients were involved in the review.
Declared interests
The authors declared no commercial or financial relationships that could be a conflict of interest. Funding came from a Canadian Institutes of Health Research project grant and AGE-WELL NCE Inc.
The easy way to misread this
Do not conclude that eHealth tools improve hip or knee replacement recovery more than usual care. Most physical and psychological comparisons showed no significant difference, and one educational video study reported higher anxiety and pain-related catastrophizing in the eHealth group.