Process evaluation of an integrated personalized eHealth programme after total and unicompartmental knee arthroplasty-Results of the multicenter ACTIVE randomized controlled trial.

In 30 seconds

This process evaluation accompanied the multicenter randomized controlled ACTIVE trial of an integrated, personalized eHealth programme for working-age patients undergoing total or unicompartmental knee arthroplasty. Among 145 patients randomized to the intervention group, 133 began follow-up; all intervention components were delivered as planned, and 99% of patients logged into the programme at least once. Patients generally found it supportive and motivating, although those with disabling comorbidities or atypical recovery felt its recommendations did not meet their needs. The authors considered it suitable for implementation in patients with a typical recovery course, with greater flexibility needed for others.

Key findings

• All intervention components were delivered as planned, and 100% of eligible patients received access to the eHealth programme.
• Adherence was high: 99% of patients logged into the programme at least once.
• The activity tracker received mean scores of 7.8 (SD 1.4) at 6 weeks and 7.9 (SD 1.4) at 6 months postoperatively.
• Patients with disabling comorbidities or atypical recovery trajectories felt the recommendations did not adequately address their needs.

Why it matters

The evaluation suggests that an integrated eHealth programme can be delivered and used as intended after knee arthroplasty, while highlighting that acceptability does not ensure suitability for every recovery course. Identifying where recommendations fail to fit patients with comorbidities or atypical progress can inform programme refinement and implementation planning.

What to keep in mind

The process evaluation collected patient data only from the intervention group, and the in-depth experience component comprised six patient interviews.