Face-to-Face Briefing Improves Outcomes

It pays to do it face to face.

A study conducted at the Hospital for Special Surgery found that joint replacement patients benefited from a one-on-one education session provided by a physical therapist. The patients were more satisfied with their pre-surgery education and felt better prepared to leave the hospital after joint replacement, compared to those who did not participate in the session or have access to the website.

“Controversy exists regarding the most effective means of delivering preoperative physical therapy education prior to total joint replacement, ” said lead investigator Rupali Joshi, PT, Ph.D. “Our study sought to evaluate the effect of a face-to-face counseling session.” The goal of the half-hour sessions, which generally took place on the patients’ pre-surgical, screening day, was to educate them on what to expect when undergoing joint replacement.

They found that patients who received one-on-one counseling also needed fewer physical therapy sessions in the hospital before discharge and met PT discharge criteria sooner. This includes the ability to get out of bed and walk with or without an assistive device and going up and down stairs independently.

In the study, researchers followed 126 patients who underwent knee or hip replacement between February and June 2015. All of the patients attended a group education class before surgery. They were then randomized into two separate groups. The median age in both groups was 61.

In group one, 63 patients attended the one-on-one education session with a physical therapist in addition to the group class. They also were granted access to the informational web portal, which also could be accessed on mobile phones and tablets, and included videos.

The control group of 63 patients attended the standard group class and received a booklet about what to expect after joint replacement. They received no further education.

“Significantly more patients who attended the extra one-on-one counseling session with the physical therapist before surgery indicated that they were better prepared to leave the hospital after surgery and were overall more satisfied with the preoperative education they received, ” Joshi noted. “Almost 97 percent of these patients accessed the informational web portal, and all of them said they would recommend it for patients undergoing the same procedure.”

Almost 70% of patients from the group that did not receive the supplemental educational session or web portal access believed they could have benefited from additional education before surgery. Patients who received one-on-one counseling also needed fewer physical therapy sessions in the hospital before discharge and met PT discharge criteria sooner.