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Completed

NCT Number: NCT04001699

Interprofessional Preoperative Geriatric Assessment for Older Arthroplasty Patients With Multimorbidity

The objective of this randomized control trial is to investigate effects and cost effectiveness of interprofessional preoperative assessment among older knee or hip arthroplasty patients. The main hypothesis is that preoperative assessment and optimization have a positive impact on the patents' quality of life and expenditure of social and health care services.

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Key information

Conditions

Multimorbidity Arthritis Hip Arthrosis Joint Diseases Knee Arthrosis Musculoskeletal Diseases Osteoarthritis Osteoarthritis, Hip Rheumatic Diseases

Age range

65 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Eastern Finland

Kuopio, FI-70211, Finland

About this study

Knee and hip arthrosis are common conditions among older adults. Progression of arthrosis often leads to worsening of symptoms and decreased mobility, daily functioning and quality of life. Total joint arthroplasty improves pain in end-stage arthrosis but accustomed postoperative care and rehabilitation alone may not guarantee optimal regain of functioning for frail and vulnerable older arthroplasty patients. Preoperative optimization of older patients with multimorbidity and functional limitations may improve benefits of the arthroplasty even at lower costs. Patients randomized into intervention arm of the present study receive preoperative assessment with treatment and prehabilitation plan. The focuses of the intervention are patient's chronic conditions, nutritional status, medication and physical activity. The intervention is delivered by multiprofessional team (geriatrician, registered nurse, physiotherapist and pharmacist).

Older adults undergoing surgery are a rapidly growing but vulnerable patient group. Knowledge on effects of preoperative evaluation and optimization is sparse, especially on the effects of multi-domain interventions.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Place of residence: Kuopio or Vesanto municipality
  • Age ≥ 65 years
  • Clinical decision for knee or hip arthroplasty, elective operation with more than one month waiting time, primary arthroplasty of the index joint.
  • Multimorbidity: the patient has at least two chronic diseases with potential to affect functioning, diseases are defined according to the Function Comorbidity Index (FCI)

Additional inclusion criteria, at least two of the following:

  • 5 or more medicines taken regularly (polypharmacy)
  • continuous walking distance less than 500 m
  • needs help in dressing and/or washing oneself
  • needs help when visiting or taking care of businesses outside home
  • body mass index ≤ 23 or ≥ 34

Exclusion criteria

  • does not meet the above inclusion criteria

Treatment and study plan

Preoperative geriatric assessment

Other

In addition to the usual care, patients randomized to the intervention group receive preoperative assessment conducted by an interprofessional team including geriatrician, registered nurse, physiotherapist and pharmacist. Based on the assessment, a preoperative optimization plan is constructed focusing on the treatment of the patient's chronic conditions, nutritional status, medication and physical activity.

Primary outcomes

  1. Health-related quality of life (15-D)

    Time frame: Preoperative measurement at baseline, postoperative measurements 3 and 9 months after the arthroplasty.

    Change in quality of life is measured using the 15-dimensions health-related quality of life questionnaire (15-D) in three time points

  2. Costs of social and health care services

    Time frame: Changes in costs of care are evaluated for a period starting from one year before and ending two years after the baseline examinations.

    Data on the use and costs of social and health care services are obtained from the national and local care registers. The costs of the intervention are evaluated by measuring working time of the inter-professional team members (used per every study patient).

Sponsors and collaborators

Lead sponsor

University of Eastern Finland

Other

Collaborators

  • Kuopio University Hospital

Registry information

Official study title

Interprofessional Preoperative Geriatric Assessment for Older Arthroplasty Patients With Multimorbidity - a Randomized Clinical Trial

Acronym: IPPGA-RCT

Important dates

Study start
2019
Primary completion
2025
Study completion
2025
First posted
Jun 28, 2019
Registry last updated
May 15, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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