Use of a web-based app to improve postoperative outcomes for patients receiving gynecological oncology care: A randomized controlled feasibility trial.

Autor: Graetz I; College of Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Ste. 633, Memphis, TN 38163, United States. Electronic address: igraetz@uthsc.edu., Anderson JN; College of Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Ste. 633, Memphis, TN 38163, United States., McKillop CN; Department of Economics, State University of New York at Cortland, 28 Graham Ave., Cortland, NY 13045, United States., Stepanski EJ; College of Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Ste. 633, Memphis, TN 38163, United States; Vector Oncology, 6555 Quince Rd #400, Memphis, TN 38119, United States., Paladino AJ; College of Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Ste. 633, Memphis, TN 38163, United States., Tillmanns TD; College of Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Ste. 633, Memphis, TN 38163, United States; West Cancer Center, 7945 Wolf River Blvd, Germantown, TN 38138, United States.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2018 Aug; Vol. 150 (2), pp. 311-317. Date of Electronic Publication: 2018 Jun 11.
DOI: 10.1016/j.ygyno.2018.06.007
Abstrakt: 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.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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