Feasibility and acceptability of mobile phone-based triage tool to identify discharged trauma patients in need of further care in Cameroon.
Feasibility and acceptability of mobile phone-based triage tool to identify discharged trauma patients in need of further care in Cameroon.
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DOI：
10.1136/tsaco-2023-001157
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发表时间：
2023
影响因子：
2
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中科院分区：
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创伤患者出院后缺乏常规随访可能导致喀麦隆受伤相关并发症的高发率。手机联系可以促进及时随访并减少高危患者的残疾。之前的一项单中心研究显示了移动医疗（mHealth）分类的可行性，但普遍性仍未知。我们评估了在喀麦隆四家医院实施出院后移动医疗分诊工具的可行性和可接受性。我们在出院后 2 周、1、3 和 6 个月时联系了来自四家喀麦隆医院的创伤患者。通过计算成功接触的比例和总体成本来评估项目的可行性。使用广义估计方程比较患者社会经济状况的成功接触几率。在出院后 2 周和 6 个月时使用结构化患者调查评估可接受性。在 3896 名创伤患者中，59% 的人在出院后 2 周时成功取得联系。其中，1 个月、3 个月和 6 个月时间点分别成功达到 87% (1370/1587)、86% (1139/1330) 和 90% (967/1069)。每次接触患者的平均费用为 3.17 美元 (IQR 2.29–4.29)。较高的社会经济地位与成功的接触独立相关；农村贫困患者最不可能获得服务（调整后 OR 0.11；95% CI 0.04 至 0.35）。几乎所有接受调查的患者都表示，基于电话的分诊是一种可接受的随访方法。在喀麦隆，电话联系是对出院后创伤患者进行分类的一种可行且可接受的方式。虽然扩大移动医疗后续计划在降低这种情况下的伤害发病率方面具有巨大潜力，但仍需要进一步研究来优化社会经济边缘群体的包容性。 III级，前瞻性观察研究。
Lack of routine follow-up for trauma patients after hospital discharge likely contributes to high rates of injury-related complications in Cameroon. Mobile phone contact may facilitate timely follow-up and reduce disability for high-risk patients. A previous single-center study showed promising feasibility of mobile health (mHealth) triage, but generalizability remains unknown. We evaluated the feasibility and acceptability of implementing a postdischarge mHealth triage tool at four hospitals in Cameroon. Trauma patients from four Cameroonian hospitals were contacted at 2 weeks, 1, 3, and 6 months postdischarge. Program feasibility was assessed by calculating the proportion of successful contacts and overall cost. Odds of successful contact were compared using generalized estimating equations across patient socioeconomic status. Acceptability was assessed using a structured patient survey at 2 weeks and 6 months postdischarge. Of 3896 trauma patients, 59% were successfully contacted at 2 weeks postdischarge. Of these, 87% (1370/1587), 86% (1139/1330), and 90% (967/1069) were successfully reached at the 1-month, 3-month, and 6-month timepoints, respectively. The median cost per patient contact was US$3.17 (IQR 2.29–4.29). Higher socioeconomic status was independently associated with successful contact; rural poor patients were the least likely to be reached (adjusted OR 0.11; 95% CI 0.04 to 0.35). Almost all surveyed patients reported phone-based triage to be an acceptable follow-up method. Telephone contact is a feasible and acceptable means to triage postdischarge trauma patients in Cameroon. While scaling an mHealth follow-up program has considerable potential to decrease injury morbidity in this setting, further research is needed to optimize inclusion of socioeconomically marginalized groups. Level III, prospective observational study.