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Mobile Application's Effect on Patient Satisfaction and Compliance in Total Joint Arthroplasty: A Systematic Review
Rubén Monárrez1, Amin Mohamadi, Jacob M Drew
1From the Department of Orthopaedic Surgery (Dr. Mohamadi, Dr. Drew), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (Dr. Monárrez, Dr. Mohamadi, Dr. Drew, and Dr. Abdeen); the Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD (Monárrez); and the Department of Orthopaedic Surgery, Boston Medical Center, Boston, MA (Abdeen).
Abstract:
Use of mobile applications to improve patient engagement is particularly promising in total joint arthroplasty (TJA) whereby successful outcomes are predicated by patient engagement. In accordance with published guidelines by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, studies were searched, screened, and appraised for quality on various search engines. Hedges' g or odds ratios of patient adherence were reported. Twelve studies met the inclusion criteria, and the average age of 9,521 patients included was 60 years. Six studies concluded that mobile applications improved patients' satisfaction, with Hedges' g revealing an effect size of 1.64 (95% confidence interval [CI] 0.90 to 2.37), P < 0.001, in favor of mobile applications increasing patient satisfaction. Six studies reported improvements in compliance demonstrating an odds ratio for improved adherence of 4.57 (95% CI, 1.66 to 12.62), P < 0.001. Two studies reported a reduction in unscheduled office or emergency department visits. With evolving reimbursement policies linked to outcomes paired with the exponentially increasing volume of TJA performed, innovative ways to efficiently deliver high-quality care are in demand. Our systematic review is limited by a dearth of research on the nascent technology, but the available data suggest that mobile applications may enhance patient satisfaction, improve compliance, and reduce unscheduled visits after TJA.

