医学
四分位间距
随机对照试验
结直肠外科
患者满意度
焦虑
物理疗法
内科学
外科
腹部外科
精神科
作者
Amandeep Pooni,Mantaj S. Brar,Tharani Anpalagan,Selina Schmocker,Saira Rashid,Rachel Goldstein,Alifiya Goriawala,Alexandra Easson,Erin Kennedy
出处
期刊:Annals of Surgery
[Ovid Technologies (Wolters Kluwer)]
日期:2022-07-11
卷期号:277 (5): e1056-e1062
被引量:1
标识
DOI:10.1097/sla.0000000000005527
摘要
A randomized controlled trial was conducted to evaluate the effect of a postdischarge app on 30-day readmissions and patient-reported outcomes following colorectal surgery.Patients undergoing colorectal surgery are particularly vulnerable during their transition from hospital-to-home. There has been increasing interest in e-health to provide cost-effective transitional care. An integrated discharge monitoring program using a mobile app platform was developed to support patients after surgery.A 2 arm, superiority randomized control trial was conducted at an academic tertiary care center with patients undergoing elective colorectal surgery. The intervention group received usual postoperative care and postdischarge monitoring with the app. The primary outcome was 30-day readmissions following hospital discharge.Two hundred eighty-two participants were randomized. The majority were young, had inflammatory bowel disease and underwent laparoscopic surgery. Intention to treat analysis showed no difference between groups for 30-day readmission (14.8% vs 17.6%, P=0.55), ER visits (25.0% vs 28.8%, P=0.49), primary care visits (12.5% vs 8.8%, P=0.34) or unplanned healthcare visits (34.4% vs 35.2%, P=0.89). All patient reported outcomes were significantly improved with median scores higher with the app for satisfaction [9, interquartile range (IQR): 8-10 vs 8, IQR: 7-9, P=0.001], well-being (7, IQR: 6-8 vs 6, IQR: 5-7, P=0.001) and significantly lower for anxiety (3, IQR: 2-5 vs 5, IQR: 3-6, P=0.001).Although the app did not show a significant reduction in 30-day readmission or ER visits, it did lead to significant improvements in patient-reported outcomes. The app may be an important tool to support patients following colorectal surgery.
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