One moderate quality study (5) examined a multicomponent educational and psychological self-management intervention for patients on wait lists for THR/TKR and compared this to a usual care
control group. The intervention consisted of a face-to-face goal setting session (‘Partners in Health’ interview) with a research nurse and the formulation of a detailed self-management care plan, along with monthly telephone follow-ups to reinforce self-management strategies (the average number of calls made to each participant was 5.2). Participants in the intervention group also had access to a traditional education component and peer support telephone calls. Patients were followed up after six months, regardless of whether they had undergone surgery.
Stiffness:
Might be effective (one moderate quality study showing a significant improvement for the intervention compared to control). (5)
Health Education Impact (2):
Inconsistent (one moderate quality study, inconsistent effects across the different domains measured).(5)
Pain:
Might not be effective (one moderate quality study showing no effect for the intervention compared to control). (5)
Function:
Might not be effective (one moderate quality study showing no effect for the intervention compared to control). (5)
Health Related Quality of Life:
Might not be effective (one moderate quality study showing no effect for the intervention compared to control). (5)
Depression:
Might not be effective (one moderate quality study showing no effect for the intervention compared to control). (5)
Evidence Service comments:
It should be noted that some participants in both the intervention and control groups underwent surgery during the follow-up period, but were still counted in the analyses, so the findings relate to participants who are both still waiting for surgery and who have already undergone surgery.
One moderate quality study(4) examined the effect of a multicomponent pain management programme for patients awaiting THR surgery and compared this to a control group receiving no intervention.
The pain management programme received by the intervention group was delivered in group sessions 1-2 mornings per week over 6 weeks. The programme aimed to educate patients to bring about behaviour change and address fears. It included psychological, practical, and physical techniques for minimising pain, disability and its impact on mood, social role, and healthcare use. Taught relaxation was also included.
All participants regardless of group allocation also received written information and advice, and exercise instructions prior to being randomised for the study. In the Intervention group, this exercise was strongly emphasised as part of the pain management programme, but it was not further emphasised for the control group.
Pain:
Might be effective (one moderate quality showing significant improvement in the intervention group compared to control). (4)
Health status:
Might not be effective (one moderate quality study showing no effect for the intervention compared to control). (4)
Function:
Might not be effective (one moderate quality study showing no effect for the intervention compared to control). (4)
Analgesic drug use:
Might not be effective (one moderate quality study showing no effect for the intervention compared to control). (4)
Delay/cancellation of surgery:
Might not be effective (one moderate quality study showing no differences between intervention and control in decisions to delay hip replacement). (4)