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Clinical and Cost Effectiveness of Physiotherapy Interventions Following Hip Replacement- A Systematic Review

Fatoye, Francis and Wright, Julie M and Yeowell, Gillian and Gebrye, Tadesse (2019) Clinical and Cost Effectiveness of Physiotherapy Interventions Following Hip Replacement- A Systematic Review. In: ISPOR conference 2019, 18 May 2019 - 22 May 2019, New Orleans, USA.


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Objectives Osteoarthritis (OA) of the hip is the leading cause of pain and disability. Total hip replacement (THR) is a common procedure for end-stage hip OA. Physiotherapy interventions are used for restoring mobility, reducing pain, and improve quality of life (QoL) following THR. This systematic review examined the clinical and cost effectiveness of physiotherapy interventions following THR. Methods A systematic review was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). MEDLINE, CINAHL, AMED, DARE, HTA and NHS EED databases were searched for studies on clinical and cost- effectiveness of physiotherapy in adults with THR published up to September 2018. Studies meeting the inclusion criteria were identified and key data was extracted. Descriptive synthesis was used to summarise the data. Results Four hundred and three studies related to the aim of the review were identified, however, from which 9 studies met the inclusion criteria and were included. These studies were conducted in Australia (n = 3), USA (n = 2), Turkey (n = 1), Iran (n = 1), Germany (n = 1), and Norway (n = 1). The duration of follow up ranged from 2 months to 2 years. The majority of the studies reported improvement in QoL, function and pain in the groups that were treated with physiotherapy interventions. Physiotherapy interventions were cost-effective following THR from healthcare perspective for a follow up period of six months. Conclusions The findings of the review suggest that physiotherapy interventions were both clinically and cost effective for people with THR. However, questions remain on the pooled clinical and cost effectiveness of physiotherapy interventions, and further research is required to examine this in patients with THR. Future studies are required to examine the cost-effectiveness of these interventions from patients/ caregivers, and societal perspective.

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