App-based or Live Patient Education before Hip Arthroplasty: A Randomized Controlled Trial

Abstract

The isolated effect of preoperative patient education on hospital length of stay (LOS) is controversial. Various educational modalities exist, yet evidence of their comparative effectiveness remains limited. We compared the effect of different preoperative education methods on LOS, postoperative outcomes, and patient satisfaction in patients undergoing primary THA. In this prospective, randomized controlled trial, 79 patients scheduled for primary THA were allocated to one of three groups: 29 received only a booklet and information during the preoperative outpatient clinic, 24 received an additional live information session and 26 used an additional mobile application. The primary outcomes were LOS and patient satisfaction regarding the information method. Secondary outcomes included Oxford Hip Score, EQ-5D-3L and EQ-VAS. Mean LOS was 4.25 ± 3 days, with no significant difference between groups (p = 0.525). Overall, there were no significant differences in satisfaction with the education method (p = 0.997) and its informational content (p = 0.365) between the groups. Patients in the mobile application group reported slightly higher motivation for pre- and postoperative exercises, though this was not statistically significant. All groups showed significant improvements in PROMs postoperatively (p < 0.001), with no significant differences in the magnitude of change between groups. The method of preoperative education did not significantly influence LOS, patient satisfaction, or postoperative outcomes in THA patients. The additional cost of implementing preoperative live sessions and mobile applications to provide additional information must be weighed against the limited benefits.