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±¬ÁÏTV the study

IDAPO is a £3.8 million programme grant, funded by the National institute for Health and Care Research (NIHR). The programme is sponsored by Sheffield Teaching Hospitals NHS Foundation Trust and co-led by Chief Investigator Ines Rombach (Clinical Trials Research Unit, ±¬ÁÏTV) and Anthony Palmer (The University of Oxford).

This project is funded for 6 years and will consist of 6 work packages focused on the development of a day-case arthroplasty pathway.

Background

Hip and Knee arthroplasty evidently provides substantial improvements in pain relief and physical function for patients with end-stage osteoarthritis, with an excess of 200,000 procedures undertaken annually in the UK. Day-case surgery is seen to be the best standard of care for arthroplasty, as this allows for more patients to receive faster care and the reduction of medical costs. However, fewer than 50% of hospitals discharge patients on the same day as surgery, resulting in the mean length of hospital stay remaining at greater than two nights.

IDAPO aims to develop and implement an inclusive day-case arthroplasty pathway, through the analysis of national data and surveys and qualitative interviews with patients and staff.

Research aims and objectives

• To understand current practices and costs of day-case hip and knee arthroplasty via routine data.
• To explore patient and staff experiences of day-case arthroplasty, through the use of surveys and interviews.
• To gather current evidence of day-case arthroplasty interventions that improve feasibility and outcomes.
• To co-design an inclusive day-case pathway, including relevant training packages and resources.
• To conduct a randomised controlled trial to evaluate the implementation of day-case hip and knee arthroplasty.
• To disseminate the findings and implement positive change.

Work packages

Work package 1- Aims to understand the current practices and inequalities of day-case hip and knee arthroplasty, using data from the National Joint Registry, Hospital Episode Statistics and Patient Reported Outcomes Measures.

Work package 2- Aims to explore patient and care giver experiences, to understand barriers and facilitators of day-case arthroplasty. This is a mixed methods work package, consisting of surveys and qualitative interviews. The research team plans to focus on recruiting ethnic minorities and those of lower socioeconomic groups.

Work package 3- Aims to establish current evidence of interventions that improve the feasibility and outcomes of day-case arthroplasty.

Work package 4- Aims to co-design a day-case pathway with relevant training packages and resources for patients and care givers. This will consist of workshops with key stakeholders and Patient and Public Involvement members to develop an inclusive and effective pathway.

Work package 5- Aims to evaluate the implementation of the day-case pathway, using a randomised controlled trial of 1406 patients from 20 sites, comparing day-case pathways with standard care.

Work package 6- Aims to disseminate the findings and implement positive change through engagement events and updating relevant guidance.

Patient and public involvement

Three patient groups were asked for their feedback and experiences of day-case surgery for hip and knee arthroplasty, and all agreed how important this research was to improving patient experiences. The IDAPO research team will work with PEP-R, a patient group from Bristol, to help deliver the research.

Study team

Co-applicants