Home News Counseling, education prior to TJA may improve outcomes in high-risk patients

Counseling, education prior to TJA may improve outcomes in high-risk patients


September 14, 2022

1 min read


Turcotte reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

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Published results showed high-risk patients who received individualized nurse navigator counseling and education prior to undergoing total joint arthroplasty experienced similar outcomes to the broader patient population.

“This study demonstrates that, when provided with appropriate resources, such as nurse navigator counseling and education, high-risk patients can achieve similar outcomes to the general lower-risk population undergoing TJA,” Justin J. Turcotte, PhD, MBA, told Healio. “Further, the use of the nurse navigator-led [enhanced preoperative education pathway] program mitigated disparities between African American and non-African American patients.”

Doctor with patient
Source: Adobe Stock

Turcotte and colleagues compared demographics, comorbidities and outcomes of 1,716 patients who underwent unilateral primary total hip or knee arthroplasty between Sept. 1, 2020, and Sept. 31, 2021, and were treated through either an enhanced preoperative education pathway program (n=802) or routine care (n=914). Researchers also performed a subgroup analysis of outcome differences by race.

Justin J. Turcotte

Justin J. Turcotte

Results showed patients in the enhanced preoperative education pathway program had a higher comorbidity burden as measured by the Charlson Comorbidity Index. Although risk adjustment showed no significant relationship between utilization of an enhanced preoperative education pathway program and length of stay, home discharge or 30-day readmissions, researchers found patients who went through the education program were less likely to return to the ED 30 days postoperatively. Researchers did not observe significant differences in outcomes between African American patients and patients who were not African American.

“By tailoring preoperative education and support programs based on level of risk, we may improve the equity of care delivered across populations,” Turcotte said. “Increased adoption of programs, such as the one described [in the study], is feasible using resources already available at many institutions and may help reduce disparities in orthopedic patients.”

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