Randomized Controlled Trial - Perioperative Telemonitoring of Patient Generated Health Data in Gastrointestinal Oncologic (GI) Surgery

Objective: To determine whether perioperative monitoring with nursing triage intervention is feasible and improves surgical outcomes and recovery. Background: There are increased demands for outpatient recovery after complex gastrointestinal oncologic surgery with simultaneous expectations of improving quality of life and expedited functional recovery. Telemonitoring is a proposed mechanism to achieve these goals. Methods: This prospective randomized controlled trial was conducted at a single institution from October 2021 to July 2023, and follow-up was completed in August 2023. Adult patients undergoing gastrointestinal oncologic surgery were randomized to either the telemonitoring intervention arm or the enhanced usual care control arm. Patient-generated health data (PGHD) and electronic patient-reported outcomes (ePROs) were assessed at discharge, 2 days, 7 days, 14 days, and 30 days post-discharge. The telemonitoring intervention arm additionally received nursing triage support when PGHD deviated from defined thresholds. Results: 129 participants (median [IQR] age, 53 [47-65]; 43% female) were randomized. 50 (39%) lived >50 miles from the medical center. Overall attrition was 12%, and there were no differences in feasibility, retention, or acceptability between arms. Postoperative complications and readmission rates were similar between arms. The intervention arm reported significantly lower MD Anderson Symptom Inventory (MDASI) interference with activity and symptom severity scores at multiple time points compared to the control arm ( P <0.05). Conclusions: This trial demonstrates that perioperative telemonitoring is feasible and acceptable. Improved ePROs in the intervention arm suggests that nursing triage intervention may help augment postoperative recovery.