This study aims to evaluate the effectiveness of a digital patient education solution, CHUVeduc@home, in improving preoperative preparation for patients undergoing total hip or knee arthroplasty. In Switzerland, many patients receive joint replacements each year to relieve osteoarthritis-related pain. With shorter hospital stays, adequate preparation before surgery has become increasingly important.
A total of 160 patients will be randomized into two groups:
Intervention group: access to CHUVeduc@home before surgery. Control group: standard preoperative preparation (group information session and consultation).
All participants will complete questionnaires through the application. No additional visits are required. The intervention lasts approximately 12 weeks.
The primary goal is to determine whether digital education increases patient knowledge, confidence, and satisfaction, and facilitates recovery and return home after surgery. Participation is voluntary and can be withdrawn at any time.
male and female patients admitted to the CHUV musculoskeletal department during the study period
primary total hip replacement or primary total knee replacement
a Risk Assessment and Prediction Tool (RAPT) score >6
a RAPT score <6,
knee/hip arthroplasty revision surgery
inability to give informed consent or answer questionnaires knowledgeably due to language or cognitive impairment as reported in the medical record
Parallel
Digital Preoperative Education with CHUVeduc@home
BehavioralThe intervention consists of a personalized digital education program delivered through the CHUVeduc@home mobile application, integrated within the existing CHUV@home platform. The application is available to patients 2 to 6 weeks prior to surgery and provides: * Educational modules covering postoperative recovery, pain management, rehabilitation, and discharge planning. * Quizzes and knowledge tests to reinforce patient understanding. * Practical advice sheets for concrete preparation. * Individualized pacing and guidance tailored to patient needs. * Notifications prompting completion of study questionnaires. The goal of the intervention is to improve patient health literacy, reduce preoperative anxiety, increase confidence, and facilitate recovery and return home after total hip or knee arthroplasty.
Standard Care Pathway
BehavioralThe main steps include: * Consultation with the surgeon * Group information session * Preoperative consultation * Hospital stay for surgery * Discharge and return home * Telemonitoring with CHUV@home after surgery * Postoperative follow-up visit at 6 weeks Participants in this group also use the CHUV@home application to complete study-specific questionnaires; however, they do not receive any additional educational content prior to surgery.
Number of patient calls to the remote care center (CTS)
The primary outcome is the total number of calls initiated by patients to the remote care support center (CTS) during the intervention period. This measure will assess the impact of the digital education tool on patient autonomy and the need for additional support. A lower number of calls is expected to reflect improved patient preparation and self-management.
Reason for contacts, the severity of alerts
This secondary objective aims to analyze the specific reasons for patient contacts, assess the severity of alerts generated, and evaluate the potential financial benefits associated with a decrease in the number of contacts, thereby providing a comprehensive understanding of the impact of the telemonitoring intervention.
Patient-reported health status and quality of life (EQ-5D-5L)
Generic health-related quality-of-life measure including five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) and a visual analogue scale (VAS). Range: Index score: typically ranges from \<0 (health states worse than death) to 1 (perfect health). VAS: 0 to 100, where 100 indicates the best imaginable health. Direction: Higher scores reflect better health status.
Patient satisfaction (ANQ questionnaire)
Patient satisfaction with hospital care will be evaluated using the Association Nationale pour la Qualité (ANQ) patient satisfaction questionnaire. The ANQ questionnaire includes multiple items each rated on a Likert scale from 1 to 5, where higher scores indicate greater satisfaction. Depending on the domain structure used locally, total scores typically range from 1 (lowest satisfaction) to 5 (highest satisfaction) per item; domain or global scores are expressed as mean values, with higher values reflecting better satisfaction with care.
Patient engagement (Patient Activation Measure [PAM-13]
Patient engagement in disease management and surgical preparation will be assessed using the Patient Activation Measure-13 (PAM-13). The PAM-13 contains 13 items, each scored from 1 (strongly disagree) to 4 (strongly agree). Raw scores are converted to a standardized activation score ranging from 0 to 100. Higher scores indicate greater patient activation, confidence, and involvement in their own health management. Scores classify patients into four activation levels, with Level 1 = lowest activation and Level 4 = highest activation.
Physical activity (International Physical Activity Questionnaire [IPAQ])
Physical activity levels will be assessed using the International Physical Activity Questionnaire (IPAQ - Short Form). The IPAQ evaluates physical activity performed in the last 7 days across four domains: walking, moderate-intensity activity, vigorous-intensity activity, and sedentary time. Scores are expressed as Metabolic Equivalent of Task (MET)-minutes per week. Total physical activity score typically ranges from 0 MET-min/week (no reported activity) to \> 3,000 MET-min/week (very high activity levels). Higher MET-min/week scores indicate higher levels of physical activity. Participants will also be classified into the IPAQ categories: Low physical activity, Moderate physical activity, High physical activity, based on standard IPAQ scoring guidelines.
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