Use of a web-based app to improve postoperative outcomes for patients receiving gynecological oncology care: A randomized controlled feasibility trial
Use of a web-based app to improve postoperative outcomes for patients receiving gynecological oncology care: A randomized controlled feasibility trial
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DOI：
10.1016/j.ygyno.2018.06.007
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发表时间：
2018-08-01
影响因子：
4.7
通讯作者：
Tillmanns, Todd D.
中科院分区：
文献类型：
--
作者：
Graetz, Ilana;Anderson, Janeane N.;Tillmanns, Todd D.
Objective.近五分之一因卵巢癌手术住院的患者因可能通过监测预防的并发症而再次入院。我们进行了一项随机对照可行性试验，以评估术后基于网络的应用程序干预，为接受开放性双侧输卵管卵巢切除术的诊断或疑似妇科癌症患者提供实时症状监测。参与者被随机分为两组：（1）应用程序+提醒：可以访问应用程序，并通过每日和/或每周提醒鼓励使用;（2）应用程序：可以访问应用程序，但没有收到提醒。应用程序显示出院说明并查询症状。患者自我报告的健康信息被整合到他们的电子健康记录中。高于预定阈值的结果触发警报，指示患者可能需要医疗干预。参与者在基线和30天随访时完成了一份问卷。他们还被邀请提供定性的，干预后的反馈。我们筛选了35例患者，招募率（74%，N = 26）和完成率（93%，N = 24）较高。App + Reminder组的参与者相对于App组更频繁地使用App（p = 0.05）。使用差异中差异（DID）分析生活质量，App +提醒组的心理健康评分相对增加（DID = 7.51，p = 0.15），但身体健康评分下降（DID =-7.49，p = 0.13）。参与者反馈表明，身体生活质量的相对下降归因于应用程序激活患者对身体症状的关注，而不是干预。该试点建立了一种新的基于网络的应用程序干预妇科肿瘤术后护理的可行性，可接受性和一些潜在的好处。(C)2018爱思唯尔公司All rights reserved.
Objective. Nearly 1 in 5 patients hospitalized for ovarian cancer surgery are readmitted for complications that may have been prevented with monitoring. We conducted a randomized controlled feasibility trial to evaluate a postoperative web-based app intervention to provide real-time symptom monitoring among patients diagnosed or with suspected gynecological cancer who had open bilateral salpingo-oophorectomy surgery.Methods. Participants were randomized into two groups: (1) App + Reminder: had access to the app, and use was encouraged with daily and/or weekly reminders: (2) app: had access to the app but received no reminders. The app displayed discharge instructions and queried symptoms. Patients' self-reported health information was integrated into their electronic health records. Outcomes above a predetermined threshold triggered alerts that indicated a patient may need medical intervention. Participants completed a questionnaire at baseline and 30-day follow-up. They were also invited to provide qualitative, post-intervention feedback.Results. We screened 35 patients, with high rates of recruitment (74%, N = 26) and completion (93%, N = 24). Participants in the App + Reminder group had more frequent app use relative to the app group (p = 0.05). Using differences-in-differences (DID) analysis for quality of life, the App + Reminder group had relative increase in the mental health score (DID = 7.51, p = 0.15) but decrease in the physical health score (DID = -7.49, p = 0.13). Participant feedback suggested the relative decrease in physical quality of life was attributable to the app activating patients' focus on physical symptoms, not the intervention.Conclusion. The pilot established feasibility, acceptability, and some potential benefits of a new web-based app intervention for gynecological oncology postoperative care. (C) 2018 Elsevier Inc. All rights reserved.