Osteoarthritis (OA) commonly affects the ageing population, particularly the hip joint. Total hip arthroplasty (THA) is a frequent procedure that relieves pain and improves mobility, though some patients experience persistent postoperative pain. With rising numbers of THA, optimising perioperative care and pain management is crucial to address the growing clinical burden and improve patient outcomes. Positive treatment expectations have shown promise in enhancing outcomes, especially in pain management. This study implements two strategies to optimise the patient’s treatment expectations, comprising enhanced physician communication and digital social observational learning. We will examine their separate and combined effects on preoperative expectations, negative emotions, postoperative pain, inflammation and function during recovery up to 12 months postoperatively.

This randomised controlled trial (RCT) investigates the impact of augmented physician communication and observational learning on treatment expectations and recovery. Participants (n=200) will be randomised into four groups: treatment as usual (TAU), augmented doctor conversation (aDOC), observational learning video (Video) and a combination of both (aDOC+Video). The aDOC group receives empathic communication and targeted information to strengthen self-efficacy. The Video group watches a model patient demonstrating successful recovery. The combined group receives both interventions. Outcomes will be assessed at multiple time points (4 days preoperatively; 1 and 4 days, 4 weeks and 3, 6 and 12 months postoperatively), including subjective pain ratings, mobility and objective physical function. The primary analysis will compare changes in pain intensity across groups. Secondary outcomes will include functional status, self-efficacy, recovery and systemic inflammatory markers. Statistical analysis involves repeated measures ANOVA and post hoc tests for between-group and within-group comparisons.

German Clinical Trials Register: DRKS00033212.

Asynchronous telemedicine-based second opinions, using a purely document-based and written procedure, offer an opportunity to support patients in their medical decision-making, particularly those who cannot secure a timely face-to-face appointment nearby. The aim of the study is to investigate the benefits and challenges of asynchronous telemedicine in obtaining a second opinion and clarify for whom and under what conditions it is suitable.

We conducted a qualitative interview study as part of a larger mixed-methods study. The interviews were transcribed verbatim and analysed using qualitative content analysis.

Germany.

The study involved 40 patients (20 women and 20 men) who sought an asynchronous telemedicine-based second opinion via an online platform, predominantly for orthopaedic issues.

Asynchronous telemedicine-based second opinions offer advantages such as access to distant specialists, the ability to consult from home without waiting times, timeliness and a detailed, fact-based report. However, the absence of face-to-face contact presents challenges: it can feel impersonal, technical problems may arise, it can be difficult to articulate symptoms and medical history in writing, and spontaneous interaction or correction is limited.

Under certain conditions, telemedicine-based second opinions can be individualised without face-to-face interaction. Key factors for success include a clear medical question, a well-organised process with good customer support, comprehensive and individualised information, and patient readiness (technical skills, internet access and the ability to articulate symptoms in writing). Major challenges for the German healthcare system include overcoming a potential digital divide as certain patient groups may not be reached by digital services.