Work Burden: Anticipated Versus Actual Patient and Caregiver Burden Following Ambulatory Orthopedic Surgery

Sponsor

Hospital for Special Surgery, New York (Other)

Overall Status

Terminated

CT.gov ID

NCT02550886

Collaborator

(none)

Enrollment

Location

3.3

Duration (Months)

8.5

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

In 2011, 38.6 million hospital stays occurred in the United States at a cost of $387.2 billion. 47.9 percent involved hospitalizations during which surgical procedures were performed. Orthopedic procedures constituted the most frequently performed and most costly of operating room procedures. As the healthcare climate in the United States continues to change, there is a trend towards providing effective care in a fiscally conservative manner. Central to this strategy is the shift towards increasing ambulatory surgical procedures from surgeries requiring post-operative admission for patients. While savings to hospitals and third-party payers are implied, there may be an unrecognized increase in financial, physical, and psychosocial post-operative costs to patients undergoing ambulatory surgery and to their caregivers. Rawal et al., and McGarth and colleagues have found that patients undergoing orthopedic procedures had moderate to severe post-operative pain. We propose to present a survey to patients and their caregivers before surgery and at multiple timepoints post-operatively to acquire information on the impacts of ambulatory orthopedic surgery. In addition to assessing post-operative pain, this study serves to examine various other possible burdens to patients that have not been previously evaluated in this patient population.

REFERENCES

McGarth B, Elgendy H, Chung F, Kamming D, Curti B, King S. Thirty percent of patients have a moderate to severe pain 24 hr after ambulatory surgery: a survey of 5,703 patients. Can J Anesth. 2004; 51:886-891.

Rawal N, Hylander J, Nydahl P, Olofsson I, Gupta A. Survey of postoperative analgesia following ambulatory surgery. Acta Anesthesiol Scand. 1997; 41:1017-1022.

Condition or Disease	Intervention/Treatment	Phase
Stress, Psychological Pain	Other: Survey

Study Design

Study Type:

Observational

Actual Enrollment :

28 participants

Observational Model:

Cohort

Time Perspective:

Prospective

Official Title:

Anticipated Versus Actual Patient and Caregiver Burden Following Ambulatory Orthopedic Surgery

Study Start Date :

Dec 1, 2015

Actual Primary Completion Date :

Mar 1, 2016

Actual Study Completion Date :

Mar 10, 2016

Arms and Interventions

Arm	Intervention/Treatment
Patient/Caregiver Dyad	Other: Survey Patients and their caregivers will be asked to complete surveys about their expected and actual time taken off from work. They will also answer questions about the patient's recovery, as well as the patient/caregiver relationship.

Arm

Intervention/Treatment

Patient/Caregiver Dyad

Other: Survey

Patients and their caregivers will be asked to complete surveys about their expected and actual time taken off from work. They will also answer questions about the patient's recovery, as well as the patient/caregiver relationship.

Outcome Measures

Primary Outcome Measures

Time taken off from work--specifically, the number of extra days taken off from work by patients and their caregivers after surgery [Holding area before surgery, post-operative day 1 (POD 1), POD 7, biweekly thereafter until patient returns to baseline level of work, and two weeks after patient returns to baseline level of work]
Patients and caregivers will be considered able to return to their baseline level of work once they can fulfill all responsibilities at their current occupation with no restrictions.

Secondary Outcome Measures

Expected Burden of Recovery [Holding area before surgery, post-operative day 1 (POD 1), POD 7, biweekly thereafter until patient returns to baseline level of work, and two weeks after patient returns to baseline level of work]
Patient: pain, nausea, vomiting, doctor appointments/hospital visits, days to return to daily activities, days to achieve recovery, days missed from work, emotional duress Caregiver: days missed from work; days to return to daily activities; emotional duress; productivity, sleep, work and personal adjustments
Excess (Actual Beyond Expected) Burden of Recovery [Holding area before surgery, post-operative day 1 (POD 1), POD 7, biweekly thereafter until patient returns to baseline level of work, and two weeks after patient returns to baseline level of work]
Patient: pain, nausea, vomiting, doctor appointments/hospital visits, days to return to daily activities, days to achieve recovery beyond expected, days missed from work, emotional duress Caregiver: days missed from work; days to return to daily activities; emotional duress; productivity, sleep, work and personal adjustments

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years to 85 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Patients undergoing outpatient arthroscopic knee debridement or meniscectomy surgery
Age 18-85
Primary caregiver available during preoperative period who is employed full-time or part-time
English speaking
Patients who are employed full-time or part-time