Postoperative Care After Carpal Tunnel Release Using Short Educational Videos

NCT06647719 | Active Not Recruiting DMC

• 1 other identifier: IRB-21-1469
• Study Type: interventional
• Target: 84
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to learn if a patient-directed postoperative care program, using short educational videos, can improve patient satisfaction and reduce healthcare resource utilization in patients undergoing carpal tunnel release (CTR). The main questions it aims to answer are: Will patients in the video-based care program be more satisfied with their postoperative care? Will this approach reduce healthcare resource use and the burden on patients without increasing complication rates? Researchers will compare the video-based patient-directed care group to the standard in-person follow-up group to see if patient satisfaction and resource use differ while maintaining similar outcomes and complication rates. Participants will: Watch three short educational videos (\< 60 seconds each) on postoperative care. Schedule a suture removal appointment with a nurse at their convenience if needed. Continue to have access to their provider through traditional methods such as phone, EMR, or urgent in-person visits.

Conditions

Carpal Tunnel Syndrome; Patient Satisfaction

Keywords

Carpal tunnel release (CTR); Patient-directed care; Educational videos; Minor hand surgery

Outcome Measures

Primary Outcomes (1)

• Patient-Reported Outcome Measurement Information System (PROMIS) / Upper Extremity Computer Adaptive Test (UE CAT) / 5-Point Likert Scale

  All patient reported outcome measures will be reported at 2 and 6 weeks postoperatively. All responses will be recorded within the study's REDCap data base.

  2 and 6 weeks postoperatively

Secondary Outcomes (6)

• Time Taken Off Work

  Baseline to 6 week follow up

• Travel time.

  Baseline to 6 week follow up

• Number of Unplanned Visits

  Baseline to 6 week follow up.

• Patient Satisfaction Questionnaire

  Baseline to 6 week follow up.

• Wound Complications

  Baseline to 6 week follow up.

Study Arms (2)

Standard of Care

NO INTERVENTION

In-person group will be followed with standard -of-care postoperative clinic visits with a hand \& upper extremity orthopaedic surgeon at Carilion Clinic Institute for Orthopaedics and Neurosciences at 2 weeks and 6 weeks from date of service.

Video Management

EXPERIMENTAL

Postoperative education will be provided with 3 short videos that will be accessible to patients on all social media platforms and through MyChart with no scheduled in person postoperative visits. Patients will have a one time visit with either nurse or orthopaedic technician for suture removal 10-14 days from surgery if the participant has nonabsorbable sutures placed during surgery.

Other: Educational Videos

Interventions

Educational Videos OTHER

Subjects in the experimental group will be provided with 3 links to videos to be watched after CTR surgery. These videos will be available through YouTube, Twitter, Facebook, Instagram, TikTok, or MyChart. Videos will be available to watch multiple times at the subjects choice.

Video Management

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients undergoing either endoscopic (CPT 29848) or open CTR (CPT 64721)
• Access to a smartphone, tablet, or computer to view educational videos
• Access to internet to download or view postoperative education videos
• Age 18 or older

You may not qualify if:

• Patients undergoing any additional procedures
• Worker's compensation status
• Revision procedures
• Patients unable to utilize technology to view videos or follow instructions
• Patients with no access to internet
• Inability to provide informed consent for the study
• Patients unable to speak English fluently

Sponsors & Collaborators

• Carilion Clinic: lead
• Virginia Tech Carilion School of Medicine and Research Institute: collaborator

Study Sites (1)

Carilion Clinic Orthopaedic Surgery

Roanoke, Virginia, 24014, United States

Location

Related Publications (26)

• Greenfield PT, Manz WJ, DeMaio EL, Duddleston SH, Xerogeanes JW, Scott Maughon T, Spencer CC, Dawes A, Boden SD, Hammond KE, Wagner ER, Gottschalk MB, Daly CA, Pombo MW. Telehealth Can Be Implemented Across a Musculoskeletal Service Line Without Compromising Patient Satisfaction. HSS J. 2021 Feb;17(1):36-45. doi: 10.1177/1556331620977171. Epub 2021 Feb 21.

  PMID: 33967640 BACKGROUND

• https://www. pewresearch.org/internet/fact-sheet/social-media/?menuItem=81867c91- 92ad-45b8-a964-a2a894f873ef

  BACKGROUND

• Kim SH, Koh WU, Rhim JH, Karm MH, Yu HS, Lee BY, Shin JW, Leem JG. Preconsent video-assisted instruction improves the comprehension and satisfaction in elderly patient visiting pain clinic. Korean J Pain. 2012 Oct;25(4):254-7. doi: 10.3344/kjp.2012.25.4.254. Epub 2012 Oct 4.

  PMID: 23091686 BACKGROUND

• Denny MC, Vahidy F, Vu KY, Sharrief AZ, Savitz SI. Video-based educational intervention associated with improved stroke literacy, self-efficacy, and patient satisfaction. PLoS One. 2017 Mar 23;12(3):e0171952. doi: 10.1371/journal.pone.0171952. eCollection 2017.

  PMID: 28333925 BACKGROUND

• Kim S, Ju MK, Son S, Jun S, Lee SY, Han CS. Development of video-based educational materials for kidney-transplant patients. PLoS One. 2020 Aug 3;15(8):e0236750. doi: 10.1371/journal.pone.0236750. eCollection 2020.

  PMID: 32745145 BACKGROUND

• Veldhuijzen G, Klemt-Kropp M, Terhaar Sive Droste JS, van Balkom B, van Esch AAJ, Drenth JPH. Computer-based patient education is non-inferior to nurse counselling prior to colonoscopy: a multicenter randomized controlled trial. Endoscopy. 2021 Mar;53(3):254-263. doi: 10.1055/a-1225-8708. Epub 2020 Nov 5.

  PMID: 32702759 BACKGROUND

• Kuba MHM, Izuka BH. One Brace: One Visit: Treatment of Pediatric Distal Radius Buckle Fractures With a Removable Wrist Brace and No Follow-up Visit. J Pediatr Orthop. 2018 Jul;38(6):e338-e342. doi: 10.1097/BPO.0000000000001169.

  PMID: 29529004 BACKGROUND

• Gamble D, Jenkins PJ, Edge MJ, Gilmour A, Anthony IC, Nugent M, Rymaszewski LA. Satisfaction and functional outcome with "self-care" for the management of fifth metacarpal fractures. Hand (N Y). 2015 Dec;10(4):607-12. doi: 10.1007/s11552-015-9749-8. Epub 2015 Feb 18.

  PMID: 26568712 BACKGROUND

• Vusirikala A, Ensor D, Asokan AK, Lee AJ, Ray R, Tsekes D, Edwin J. Hello, can you hear me? Orthopaedic clinic telephone consultations in the COVID-19 era- a patient and clinician perspective. World J Orthop. 2021 Jan 18;12(1):24-34. doi: 10.5312/wjo.v12.i1.24. eCollection 2021 Jan 18.

  PMID: 33520679 BACKGROUND

• Orrange S, Patel A, Mack WJ, Cassetta J. Patient Satisfaction and Trust in Telemedicine During the COVID-19 Pandemic: Retrospective Observational Study. JMIR Hum Factors. 2021 Apr 22;8(2):e28589. doi: 10.2196/28589.

  PMID: 33822736 BACKGROUND

• Reider-Demer M, Raja P, Martin N, Schwinger M, Babayan D. Prospective and retrospective study of videoconference telemedicine follow-up after elective neurosurgery: results of a pilot program. Neurosurg Rev. 2018 Apr;41(2):497-501. doi: 10.1007/s10143-017-0878-0. Epub 2017 Jul 22.

  PMID: 28735437 BACKGROUND

• Kane LT, Thakar O, Jamgochian G, Lazarus MD, Abboud JA, Namdari S, Horneff JG. The role of telehealth as a platform for postoperative visits following rotator cuff repair: a prospective, randomized controlled trial. J Shoulder Elbow Surg. 2020 Apr;29(4):775-783. doi: 10.1016/j.jse.2019.12.004.

  PMID: 32197766 BACKGROUND

• Williams M, Amin A, Getgood A, Hallam P, Chojnowski AJ, Chapman PG. Telephone clinic follow-up following carpal tunnel decompression. J Hand Surg Eur Vol. 2008 Oct;33(5):641-4. doi: 10.1177/1753193408090124. Epub 2008 Jun 25.

  PMID: 18579622 BACKGROUND

• Grandizio LC, Mettler AW, Caselli ME, Pavis EJ. Telemedicine After Upper Extremity Surgery: A Prospective Study of Program Implementation. J Hand Surg Am. 2020 Sep;45(9):795-801. doi: 10.1016/j.jhsa.2020.06.002. Epub 2020 Jul 18.

  PMID: 32693989 BACKGROUND

• Kummerow Broman K, Roumie CL, Stewart MK, Castellanos JA, Tarpley JL, Dittus RS, Pierce RA. Implementation of a Telephone Postoperative Clinic in an Integrated Health System. J Am Coll Surg. 2016 Oct;223(4):644-51. doi: 10.1016/j.jamcollsurg.2016.07.010. Epub 2016 Aug 18.

  PMID: 27545100 BACKGROUND

• Parisien RL, Shin M, Constant M, Saltzman BM, Li X, Levine WN, Trofa DP. Telehealth Utilization in Response to the Novel Coronavirus (COVID-19) Pandemic in Orthopaedic Surgery. J Am Acad Orthop Surg. 2020 Jun 1;28(11):e487-e492. doi: 10.5435/JAAOS-D-20-00339.

  PMID: 32459409 BACKGROUND

• https://www.pewresearch.org/internet/fact-sheet/mobile/

  BACKGROUND

• Rizzi AM, Polachek WS, Dulas M, Strelzow JA, Hynes KK. The new 'normal': Rapid adoption of telemedicine in orthopaedics during the COVID-19 pandemic. Injury. 2020 Dec;51(12):2816-2821. doi: 10.1016/j.injury.2020.09.009. Epub 2020 Sep 16.

  PMID: 32951916 BACKGROUND

• Sultan AA, Acuna AJ, Samuel LT, Rabin JM, Grits D, Gurd DP, Kuivila TE, Goodwin RC. Utilization of Telemedicine Virtual Visits in Pediatric Spinal Deformity Patients: A Comparison of Feasibility and Patient Satisfaction at a Large Academic Center. J Pediatr Orthop. 2020 Sep;40(8):e712-e715. doi: 10.1097/BPO.0000000000001553.

  PMID: 32235192 BACKGROUND

• Halonen LM, Vasara H, Stenroos A, Kosola J. Routine follow-up is unnecessary after intramedullary fixation of trochanteric femoral fractures-Analysis of 995 cases. Injury. 2020 Jun;51(6):1343-1345. doi: 10.1016/j.injury.2020.03.033. Epub 2020 Mar 10.

  PMID: 32220506 BACKGROUND

• Tofte JN, Anthony CA, Polgreen PM, Buckwalter JA, Caldwell LS, Fowler TP, Ebinger T, Hanley JM, Dowdle SB, Holte AJ, Arpey NC, Lawler EA. Postoperative care via smartphone following carpal tunnel release. J Telemed Telecare. 2020 May;26(4):223-231. doi: 10.1177/1357633X18807606. Epub 2018 Nov 14.

  PMID: 30428766 BACKGROUND

• Zhang D, Blazar P, Earp BE. Rates of Complications and Secondary Surgeries of Mini-Open Carpal Tunnel Release. Hand (N Y). 2019 Jul;14(4):471-476. doi: 10.1177/1558944718765226. Epub 2018 Mar 20.

  PMID: 29557679 BACKGROUND

• Matsis R, Chou J, Clode N. Outcome of carpal tunnel decompression with pre-surgical diagnosis determined on general practitioner assessment and nerve conduction study. J Clin Orthop Trauma. 2020 Sep 6;13:15-18. doi: 10.1016/j.jcot.2020.08.028. eCollection 2021 Feb.

  PMID: 33717870 BACKGROUND

• Sun Cao P, Loewenstein SN, Timsina LR, Adkinson JM. The Association of Insurance Status and Complications After Carpal Tunnel Release. Hand (N Y). 2023 Mar;18(2):192-197. doi: 10.1177/1558944721990818. Epub 2021 Feb 25.

  PMID: 33631982 BACKGROUND

• Fajardo M, Kim SH, Szabo RM. Incidence of carpal tunnel release: trends and implications within the United States ambulatory care setting. J Hand Surg Am. 2012 Aug;37(8):1599-605. doi: 10.1016/j.jhsa.2012.04.035. Epub 2012 Jun 23.

  PMID: 22727925 BACKGROUND

• Luckhaupt SE, Dahlhamer JM, Ward BW, Sweeney MH, Sestito JP, Calvert GM. Prevalence and work-relatedness of carpal tunnel syndrome in the working population, United States, 2010 National Health Interview Survey. Am J Ind Med. 2013 Jun;56(6):615-24. doi: 10.1002/ajim.22048. Epub 2012 Apr 11.

  PMID: 22495886 BACKGROUND

MeSH Terms

Conditions

Carpal Tunnel Syndrome; Patient Satisfaction

Condition Hierarchy (Ancestors)

Median Neuropathy; Mononeuropathies; Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases; Nerve Compression Syndromes; Cumulative Trauma Disorders; Sprains and Strains; Wounds and Injuries; Treatment Adherence and Compliance; Health Behavior; Behavior

Study Officials

• Cesar Bravo, M.D.

  Carilion Clinic

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Orthopedic Hand and Upper Extremity Surgeon

Study Record Dates

• First Submitted: October 16, 2024
• First Posted: October 18, 2024
• Study Start: June 1, 2022
• Primary Completion: October 31, 2024
• Study Completion: December 31, 2024
• Last Updated: October 18, 2024

Record last verified: 2024-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)