ABSTRACT
Background: Lower limb osteoarthritis (OA) often generates musculoskeletal pain causing functional impairment and decreasing mobility, autonomy, and quality of life. Patients with OA are commonly prescribed specific care for total hip arthroplasty or total knee arthroplasty (THA or TKA), when patients present symptoms that are refractory to nondrug treatments. Currently, when patients are discharged from orthopedic surgery, they are either referred to a rehabilitation department, or sent directly home with assistance such as remote monitoring by teleconsultation or a mobile application. In recent years, there has been an evolution in digital health and in particular telerehabilitation. To determine utility and effectiveness, the aim of this systematic review was to highlight and evaluate different telerehabilitation programs using new information and communication technologies. Methods: Five databases, ScienceDirect, PubMed, Web of Sciences, Scopus, and Google scholar, were searched until 30 June 30, 2023. All studies written in English and meeting our inclusion criteria were included. Databases were screened for "Total Hip Arthroplasty," "Total Knee Arthroplasty," "Total Hip Replacement," "Total Knee Replacement," "Rehabilitation," "Physical Activity," "Physiotherapy," "Telerehabilitation," "Telecommunication*," "Senior*," and "Elderly" in accordance with PRISMA-ScR guideline. Results: Fourteen articles were selected according to inclusion criteria. Telerehabilitation was offered in seven different ways (video call, applications smartphones, website, etc.). Assessments included were mainly quality of life questionnaires, perceived effort after exercises, field surveys on the tool experience, and physical tests to assess motor functions. Conclusion: This review highlights the importance and relevance of evaluating the contributions and limits of new health technologies to improve patient monitoring and thus enable better remote clinical care.
Subject(s)
Arthroplasty, Replacement, Hip , Arthroplasty, Replacement, Knee , Telerehabilitation , Humans , Arthroplasty, Replacement, Knee/rehabilitation , Arthroplasty, Replacement, Hip/rehabilitation , Aged , Quality of Life , Osteoarthritis, Knee/surgery , Osteoarthritis, Knee/rehabilitationABSTRACT
OBJECTIVES: Self-administration consists in the administration of medications by the patient himself during his hospitalization. The order of October 10, 2022 (Arrêté du 10 octobre 2022 modifiant l'arrêté du 6 avril 2011) modified the April 6, 2011 regulation to allow and regulate self-administration practices in hospital units. This evolution opens new perspectives for patient autonomy. The objective of this study is, firstly, to evaluate the rate of medication errors from patients under self-administration and secondly, to evaluate the satisfaction of patients and caregivers. MATERIAL AND METHODS: Eligible patients were recruited from a locomotor and polyvalent rehabilitation unit. After verification of eligibility, explanation given to the patient about the hospital self-administration of medication procedure and signature of the compliance agreement, patients started self-administration. Medication errors were reported during seven days. Evaluations of patient and staff satisfaction were also carried out. RESULTS: Of the 83 patients admitted to the care service, 32 were able to experiment self-administered medication procedure during their hospitalization. To assess the safety of this practice, 1235 drug intakes were analyzed. Ninety-four administration errors were noted: 98% of them concerned analgesic drugs. All of these errors were omissions and none of them were rated as serious. The 20 patients questioned were all satisfied with self-administration. The 14 carers interviewed were satisfied with this change in practice. CONCLUSION: The medication self-administration process set up in the rehabilitation unit did not lead to serious medication errors. Patients and caregivers reported being satisfied with this new hospital practice.
