Less is known about pain and opiate use at home directly after total knee replacement (TKR). Regarding side effects, low opiate use is desired. An e-health application, PainCoach app, was developed to guide patients in pain control and opiate use. The aim of this study was to investigate the effect of the PainCoach app on pain and opiate use in TKR patients in the first two weeks at home after surgery. The hypothesis was that the use of this app would decrease pain and opiate use.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
97
In response to the patient's input of the pain experienced (no pain, bearable pain, unbearable pain, or untenable pain), the app gave advice on pain medication use, exercises/rest and when to call the clinic from day 1 until day 14 after surgery.
Kliniek ViaSana
Mill, Netherlands
Change in pain at rest in the first two weeks at home after TKR
Pain at rest was daily measured with VAS from 0 (no pain) to 100 (worst imaginable pain)
Time frame: 14 measurement points: daily from day 1 to 14 after surgery
Change in pain during activity in the first two weeks at home after TKR
Measured with VAS from 0 (no pain) to 100 (worst imaginable pain)
Time frame: 14 measurement points: daily from day 1 to 14 after surgery
Change in pain at night in the first two weeks at home after TKR
Measured with VAS from 0 (no pain) to 100 (worst imaginable pain)
Time frame: 14 measurement points: daily from day 1 to 14 after surgery
Change in opiate use in the first two weeks at home after TKR
Oxycodon (5 mg per tablet) use was recorded in quantities per 24 hours
Time frame: 14 measurement points: daily from day 1 to 14 after surgery
Pain at rest
Measured with VAS from 0 (no pain) to 100 (worst imaginable pain)
Time frame: 1 month after surgery
Pain during activity
Measured with VAS from 0 (no pain) to 100 (worst imaginable pain)
Time frame: 1 month after surgery
Pain at night
Measured with VAS from 0 (no pain) to 100 (worst imaginable pain)
Time frame: 1 month after surgery
Change in other pain medication use in the first two weeks at home after TKR
i.e. NSAID (Diclofenac), acetaminophen and/or Gabapentin were recorded in quantities per 24 hours
Time frame: 14 measurement points: daily from day 1 to 14 after surgery
Change in pain acceptance at rest, during activity and at night in the first two weeks at home after TKR
Measured with a happy smiley (acceptable pain) and a sad smiley (unacceptable pain)
Time frame: 14 measurement points: daily from day 1 to 14, and at 1 month after surgery
Change in experiences with the executed recommended physiotherapy exercises in the first two weeks at home after TKR
Measured on a 3-item scale; did too much, exactly enough, or could have done more exercises
Time frame: 14 measurement points: daily from day 1 to 14 after surgery
Function
Measured with the Knee injury and Osteoarthritis Outcome Score - Physical Function Short-form (KOOS-PS) with a total score from 0 (no difficulty) to 100 (extreme difficulty)
Time frame: 1 month after surgery
Function and pain
Measured with the Oxford Knee Score (OKS) with a total score from 0 (most severe symptoms) to 48 (least severe symptoms)
Time frame: 1 month after surgery
Quality of life
Measured with the EuroQol-5D 3 level version (EQ-5D-3L) consisting of two scores: EQ Visual Analogue Scale (EQ VAS) score from 0 (worst imaginable health state) to 100 (best imaginable health state), and EQ-5D descriptive system (EQ-5D index).
Time frame: 1 month after surgery
PainCoach app's perceived effectiveness
Usability, added value, and likelihood of being recommended to others was recorded on a 5-item scale ranging from totally agree to totally disagree
Time frame: Day 14 after surgery
Active PainCoach app use
Measured with recording the actual amount of app use and defining active use as at least 12 times in total
Time frame: From day 1 to 14 after surgery
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