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

机译：一种移动设备应用程序（应用程序），以改善对成分手术的增强恢复程序的遵守：随机对照试验

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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.
机译：背景技术与增强型恢复途径（ERP）的增加的粘附与改善的结果相关联。然而，依赖患者参与的术后元素依赖于次优。移动设备应用程序可能会改善健康教育材料的交付，并有可能促进行为的变化和改善患者的遵守。本研究的目的是估计新型移动设备应用程序与标准书面教育相比，新型移动设备应用程序对结肠直肠手术的ERP遵守的程度。方法这是一种优势，平行组，评估综合症，假控随机试验，涉及接受结直肠切除术的97例。参与者随机分配1：1的比例，进入两组之一：（1）iPad，包括用于术后教育和恢复自我评估的新型移动设备应用程序，或（2）未经应用程序的iPad。主要结果措施是指需要患者参与的五个五个术后ERP元素的束缚（％）：动员，胃肠运动刺激，呼吸锻炼和口腔液体消耗和营养饮料。结果在干预组中，APP使用率很高（POD0完成调查94％，POD1上的82％，POD2上的72％）。平均依从于两个第一个术后日的束在术语中相似：59％（95％CI 52-66％）在干预组中，对照组62％（95％CI 56-68％）[调整后平均差异2.4％（95％CI-5至10％）p = 0.53]。结论在该随机试验中，与标准书面患者教育相比，对移动健康申请的访问没有改善到结肠直肠手术患者中成熟的良好的增强恢复途径。未来的研究应该评估应用新的行为变化技术的应用的影响，特别是在坚持低的背景下。

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  • 来源
    《Surgical Endoscopy》 |2020年第2期|共10页
  • 作者

    Mata Juan; Pecorelli Nicolo; Kaneva Pepa; Moldoveanu Dan; Gosselin-Tardiff Alexandre; Alhashemi Mohsen; Robitaille Stephan; Balvardi Saba; Lee Lawrence; Stein Barry L.; Liberman Sender; Charlebois Patrick; Fiore Julio F. Jr.; Feldman Liane S.;

  • 作者单位

    McGill Univ Hlth Ctr Steinberg Bernstein Ctr Minimally Invas Surg &

    In 1650 Cedar Ave L9-309;

    McGill Univ Hlth Ctr Steinberg Bernstein Ctr Minimally Invas Surg &

    In 1650 Cedar Ave L9-309;

    McGill Univ Hlth Ctr Steinberg Bernstein Ctr Minimally Invas Surg &

    In 1650 Cedar Ave L9-309;

    McGill Univ Dept Surg Hlth Ctr Montreal PQ Canada;

    McGill Univ Dept Surg Hlth Ctr Montreal PQ Canada;

    McGill Univ Hlth Ctr Steinberg Bernstein Ctr Minimally Invas Surg &

    In 1650 Cedar Ave L9-309;

    McGill Univ Hlth Ctr Steinberg Bernstein Ctr Minimally Invas Surg &

    In 1650 Cedar Ave L9-309;

    McGill Univ Hlth Ctr Steinberg Bernstein Ctr Minimally Invas Surg &

    In 1650 Cedar Ave L9-309;

    McGill Univ Hlth Ctr Steinberg Bernstein Ctr Minimally Invas Surg &

    In 1650 Cedar Ave L9-309;

    McGill Univ Dept Surg Hlth Ctr Montreal PQ Canada;

    McGill Univ Dept Surg Hlth Ctr Montreal PQ Canada;

    McGill Univ Dept Surg Hlth Ctr Montreal PQ Canada;

    McGill Univ Hlth Ctr Steinberg Bernstein Ctr Minimally Invas Surg &

    In 1650 Cedar Ave L9-309;

    McGill Univ Hlth Ctr Steinberg Bernstein Ctr Minimally Invas Surg &

    In 1650 Cedar Ave L9-309;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 诊断学;
  • 关键词

    Recovery pathways; Technology; Mobile application; Colorectal;

    机译：恢复途径;技术;移动应用;结肠直肠;

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