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Trial registered on ANZCTR
Registration number
ACTRN12619000444189p
Ethics application status
Submitted, not yet approved
Date submitted
8/03/2019
Date registered
18/03/2019
Date last updated
18/03/2019
Date data sharing statement initially provided
18/03/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Using teach-back to improve recall of discharge information in patients with arthroplasty
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Scientific title
Using teach-back to improve recall of discharge information in patients with arthroplasty
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Secondary ID [1]
297667
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None
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Universal Trial Number (UTN)
U1111-1229-7641
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Arthroplasty
311946
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Condition category
Condition code
Musculoskeletal
310528
310528
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0
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Other muscular and skeletal disorders
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Public Health
310622
310622
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0
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Health service research
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
‘Teach-back’ involves health providers asking patients to explain in their own words what they have just been told and then working with that patient to clarify any misunderstandings. The intervention is the addition of teach-back to usual education about activity, medication and prevention of dislocation that is provided before discharge to patients with arthroplasty. This usual education is currently provided on a one-to-one basis by a clinician (usually a physiotherapist) using written resources and verbal instruction. The time taken is approximately 10-15 minutes. For the teach-back intervention, clinicians will summarise the pre-discharge information into 2-3 standardised key points and then check the patient's understanding by asking them to explain back in their own words what they have understood. The clinician will then work with the patient to clarify misunderstandings. The intervention is expected to add approximately 5 minutes to the education session. To support fidelity of the intervention, the education content will be standardised and training and resources will be provided to all staff. Staff will also be asked to record which patients received teach-back. The patient participant group are not randomised. A comparison group will comprise eligible patients admitted to the orthopaedic unit prior to staff being trained in standardised use of teach-back (i.e. 'pre-intervention'). Following staff training and implementation of teach-back, eligible patients will be allocated to the post-intervention group.
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Intervention code [1]
313904
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Behaviour
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Comparator / control treatment
Usual care will comprise the standard pre-discharge education about activity, medication and prevention of dislocation (the latter for total hip replacement (THR) patients only) that is provided before discharge to patients. his usual education is currently provided on a one-to-one basis by a clinician (usually a physiotherapist) using written resources and verbal instruction. The time taken is approximately 10-15 minutes.
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Control group
Active
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Outcomes
Primary outcome [1]
319392
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% of patients who can correctly recall discharge information about:
Three symptoms to see the doctor or the emergency department for.
How many times a day should they complete their rehabilitation exercises.
How long before exercising should they take pain medication
Responses will be yes/no for having answered correctly (based on the standardised education given to arthroplasty patients prior to discharge). These items are designed specifically for this study.
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Assessment method [1]
319392
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Timepoint [1]
319392
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2-days post-discharge
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Primary outcome [2]
319394
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Confidence of staff to undertake teach-back. This is a composite outcome derived from the Teach-Back Conviction and Confidence Scale and the validated Perceived Knowledge and Self-confidence of Paediatric Nurses as Patient Educators scale.
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Assessment method [2]
319394
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Timepoint [2]
319394
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Pre- and post-intervention (approximately 4 months between)
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Secondary outcome [1]
368002
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Patient's level of pain, using the Numeric Pain Rating Scale
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Assessment method [1]
368002
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Timepoint [1]
368002
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2-days post-discharge
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Secondary outcome [2]
368003
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Patient's self-efficacy to manage their condition at home using the Self Efficacy Expectation Scale
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Assessment method [2]
368003
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Timepoint [2]
368003
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2-days post-discharge
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Secondary outcome [3]
368012
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To assess staff satisfaction with using teach-back and barriers/enablers to its uptake, staff will be invited to a 45-minute focus group(s) at the end of the intervention period. For staff who are unable to attend the focus group due to availability, a 15-minute telephone/face-to-face interview will be offered.
The focus group/interviews will be semi-structured, and facilitated/conducted by a researcher. Both will be audio-recorded and transcribed.
There are between 6-10 eligible staff who will be invited to participate in either the focus group or interviews.
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Assessment method [3]
368012
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Timepoint [3]
368012
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Within 2-4 weeks of completion of the intervention period.
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Eligibility
Key inclusion criteria
Group one - patients: Will be discharged directly home following an elective arthroplasty. Cognitively able to receive pre-discharge education on activity, medication, (+/- prevention of dislocation for patients with total hip replacement); are able to provide informed consent; able to communicate in English.
Group two - Clinicians (nursing, allied health or medical) within the Williamstown orthopaedic unit who routinely provide pre-discharge information to patients with elective joint surgery (approximately six to ten eligible staff).
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Group one - Patients who are not considered to be clinically or otherwise appropriate for inclusion based on their treating clinician’s opinion will be excluded from this study.
Group two - clinicians. No exclusion criteria
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/04/2019
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Actual
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Date of last participant enrolment
Anticipated
1/02/2020
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Actual
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Date of last data collection
Anticipated
5/02/2020
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Actual
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Sample size
Target
64
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
13345
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Williamstown Hospital - Williamstown
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Recruitment postcode(s) [1]
25944
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3016 - Williamstown
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Funding & Sponsors
Funding source category [1]
302197
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University
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Name [1]
302197
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University of Melbourne
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Address [1]
302197
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Department of Medicine - Western Health
WCHRE Building, Level 3 / 176 Furlong Road, St Albans VIC 3021
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Country [1]
302197
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Australia
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Primary sponsor type
University
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Name
The University of Melbourne
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Address
Department of Medicine - Western Health
WCHRE Building, Level 3 / 176 Furlong Road, St Albans VIC 3021
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Country
Australia
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Secondary sponsor category [1]
302049
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None
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Name [1]
302049
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Address [1]
302049
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Country [1]
302049
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Other collaborator category [1]
280584
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Hospital
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Name [1]
280584
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Western health
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Address [1]
280584
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Sunshine Hospital
176 Furlong Road, St Albans VIC 3021
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Country [1]
280584
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Australia
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
302876
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Western Health Human Research Ethics Committee
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Ethics committee address [1]
302876
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Sunshine Hospital WCHRE Building, Level 3 / 176 Furlong Road, St Albans VIC 3021
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Ethics committee country [1]
302876
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Australia
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Date submitted for ethics approval [1]
302876
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04/03/2019
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Approval date [1]
302876
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Ethics approval number [1]
302876
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Summary
Brief summary
‘Teach-back’ can help providers identify when a patient has difficulty understanding health information. The strategy involves asking patients to explain in their own words what they have just been told and then working with that patient to clarify any misunderstandings. Evidence from multiple studies shows teach-back improves health outcomes and safety. This study aims to evaluate the use of teach-back in Western Health (WH) orthopaedic service at Williamstown Hospital. The service will implement teach-back in pre-discharge education for patients following arthroplasty. Staff and researchers will co-design a strategy for ensuring that teach-back is used in a systematic way within the unit. Teach-back will then be implemented over a 4-month period. We will evaluate the impact of teach-back on both patients and staff. For patients, we will compare outcomes between those who are admitted to the unit before and after staff are trained in teach-back. We will also survey staff to evaluate whether they feel more confident about providing education. This study will also assess the uptake of teach-back in the unit (‘implementation’). We will interview staff about their experiences using teach-back including frequency of use. Findings from this study will provide further evidence for the effectiveness of teach-back, and guidance for other services seeking to implement teach-back into routine care.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Cathy Said
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Address
91698
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Physiotherapy, The University of Melbourne
Level 3, Western Centre for Health Research and Education
Sunshine Hospital
176 Furlong Rd, St Albans
Vic 3021
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Country
91698
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Australia
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Phone
91698
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+61 383958106
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Fax
91698
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Email
91698
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[email protected]
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Contact person for public queries
Name
91699
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Alison Beauchamp
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Address
91699
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Department of Medicine - Western Health
Level 3, Western Centre for Health Research and Education
Sunshine Hospital
176 Furlong Rd, St Albans
Vic 3021
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Country
91699
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Australia
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Phone
91699
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+61 414 411 296
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Fax
91699
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Email
91699
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[email protected]
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Contact person for scientific queries
Name
91700
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Alison Beauchamp
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Address
91700
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Department of Medicine - Western Health
Level 3, Western Centre for Health Research and Education
Sunshine Hospital
176 Furlong Rd, St Albans
Vic 3021
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Country
91700
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Australia
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Phone
91700
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+61 414 411 296
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Fax
91700
0
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Email
91700
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
These data are considered as patient data maintained by Western Health and individual data will not be publicly available
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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