Patient-centered perspectives: A qualitative evaluation of the Hip Instructional Prehabilitation Program for Enhanced Recovery (HIPPER)
Aditya Dhariwal, Somayyeh Mohammadi, Ethan Simpson, Marie D. Westby, Wendy Watson, William C. Miller
Abstract
Over 55,000 total hip replacement (THR) surgeries were performed in Canada in 2021, with the number rising each year. Excluding rehabilitation, the cost of hip replacement procedures exceeded $675 million, a large burden on the Canadian healthcare system.
Introduction
In Canada, approximately 26.6% of individuals aged 50 and older have physician-diagnosed osteoarthritis (OA), which can break down joint cartilage and lead to joint pain, reducing mobility [1]. When individuals do not respond to first-line approaches including education, exercise, weight loss and medications, total joint replacement surgery becomes an option [2].
Materials and Methods
In this qualitative study, we used Qualitative Descriptive Design as that can be used in health care settings and mixed-method studies to investigate participants' perception on the quality of the intervention [23].
Results
Of the 18 participants who were interviewed, 11 participants were female, and all underwent primary total hip replacement surgery between 2021 and 2023. When asked about their gender, all participants identified consistent with their biologically assigned sex.
Discussion:
Our findings illustrate the experiences and perspectives of individuals who used HIPPER to prepare for THR surgery and recovery, showing it to be a usable and effective prehabilitation tool.
Conclusion
Prehabilitation offers a multitude of benefits by providing realistic expectations for patients and preparing them to have the best possible outcomes. Delivering a prehabilitation program through an eHealth platform improves accessibility, potential for cost-effectiveness and provides flexibility.
Citation: Dhariwal A, Mohammadi S, Simpson E, Westby MD, Watson W, Miller WC (2025) Patient-centered perspectives: A qualitative evaluation of the Hip Instructional Prehabilitation Program for Enhanced Recovery (HIPPER). PLoS ONE 20(4): e0322114. https://doi.org/10.1371/journal.pone.0322114
Editor: Stefano Turi,, IRCCS: IRCCS Ospedale San Raffaele, ITALY
Received: March 15, 2024; Accepted: March 17, 2025; Published: April 24, 2025
Copyright: © 2025 Dhariwal et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: In accordance with our institution's ethics policy, anonymizing qualitative interview transcripts does not make them fully unidentifiable, therefore data can be requested through Borealis (https://doi.org/10.5683/SP3/H6YW01) by researchers who meet the criteria for access to confidential data.
Funding: The funding for this study was provided through a Canadian Institutes of Health Research (CIHR) Project Grant (#PJT-148861; Principal Investigator: WM). SM's involvement was also supported by a CIHR Project Grant with the same reference number and Principal Investigator. It's important to note that the funding agency, CIHR, is not involved in any research activities associated with this study.
Competing interests: The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
