Grant: Project Grant

Osteoarthritis (OA), leading to hip replacement, is a leading contributor to global mobility impairment. Given the boom in the older demographic it is not surprising that there is an 11% increased demand for replacement every 5 years in Canada. In 2014, over 250 surgeries were conducted in Vancouver alone and the mean surgical waitlist period was 45 weeks in BC. Health promotion interventions, such as prehabilitation, defined as pre-surgical education, are vital to optimizing surgical outcomes, reducing hospitalization costs, accelerating rehabilitation, and reducing patient discomfort and pre-operative anxiety. The evidence, however, is mixed particularly with respect to the learning preferences and the mode of delivery. Education based on eHealth (e.g. online) principles presents considerable delivery flexibility while making the learning interesting, interactive and informative. Moreover, standardized information can be provided across broad geographical regions while reducing patient/family burden and cost to the health care system. Using a user-centred based design focusing on user input, our research team has created and refined an online prehabilitation education program called, Hip Instructional Prehabilitation Program for Enhanced Recovery (HIPPER). Here, we propose a 2-year feasibility randomized controlled trial (RCT) to assess both feasibility indicators (process, resource, management, and treatment issues) and clinical outcomes (physical function, anxiety, pain, satisfaction with education, and health related quality of life) in Vancouver-dwelling older adults aged > 50 years, with advanced hip OA. The findings of this feasibility trial will lead to the refinement of the design protocol in order to robustly evaluate a contemporary, standardized, and geographically accessible prehabilitation education program in a large multi-site RCT. Ultimately, HIPPER may be found to have significant individual and social (health system level) benefits.