A mobile device application (app) to improve adherence to an enhanced recovery program for colorectal surgery: a randomized controlled trial

被引：36

作者：

Mata, Juan ^{[1
]}

Pecorelli, Nicolo ^{[1
]}

Kaneva, Pepa ^{[1
]}

Moldoveanu, Dan ^{[2
]}

Gosselin-Tardiff, Alexandre ^{[2
]}

Alhashemi, Mohsen ^{[1
]}

Robitaille, Stephan ^{[1
]}

Balvardi, Saba ^{[1
]}

Lee, Lawrence ^{[1
,2
]}

Stein, Barry L. ^{[2
]}

Liberman, Sender ^{[2
]}

Charlebois, Patrick ^{[2
]}

Fiore, Julio F., Jr. ^{[1
,2
]}

Feldman, Liane S. ^{[1
,2
]}

机构：

[1] McGill Univ, Hlth Ctr, Steinberg Bernstein Ctr Minimally Invas Surg & In, 1650 Cedar Ave,L9-309, Montreal, PQ H3G 1A4, Canada

[2] McGill Univ, Dept Surg, Hlth Ctr, Montreal, PQ, Canada

来源：

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2020年 / 34卷 / 02期

关键词：

Recovery pathways; Technology; Mobile application; Colorectal; PERIOPERATIVE CARE; SURGICAL RECOVERY; OUTCOMES; PATHWAY; IMPLEMENTATION; GUIDELINES; MANAGEMENT; RESECTION; SOCIETY; IMPACT;

D O I：

10.1007/s00464-019-06823-w

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background Increased adherence with enhanced recovery pathways (ERP) is associated with improved outcomes. However, adherence to postoperative elements that rely on patient participation remains suboptimal. Mobile device apps may improve delivery of health education material and have the potential to foster behavior change and improve patient compliance. The objective of this study was to estimate the extent to which a novel mobile device app affects adherence to an ERP for colorectal surgery in comparison to standard written education. Methods This was a superiority, parallel-group, assessor-blind, sham-controlled randomized trial involving 97 patients undergoing colorectal resection. Participants were randomly assigned with a 1:1 ratio into one of two groups: (1) iPad including a novel mobile device app for postoperative education and self-assessment of recovery, or (2) iPad without the app. The primary outcome measure was mean adherence (%) to a bundle of five postoperative ERP elements requiring patient participation: mobilization, gastrointestinal motility stimulation, breathing exercises, and consumption of oral liquids and nutritional drinks. Results In the intervention group, app usage was high (94% completed surveys on POD0, 82% on POD1, 72% on POD2). Mean overall adherence to the bundle on the two first postoperative days was similar between groups: 59% (95% CI 52-66%) in the intervention group and 62% (95% CI 56-68%) in the control group [Adjusted mean difference 2.4% (95% CI - 5 to 10%) p = 0.53]. Conclusions In this randomized trial, access to a mobile health application did not improve adherence to a well-established enhanced recovery pathway in colorectal surgery patients, when compared to standard written patient education. Future research should evaluate the impact of applications integrating novel behavioral change techniques, particularly in contexts where adherence is low.

引用

页码：742 / 751

页数：10

共 30 条

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