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视频虚拟临床访视与盆腔器官脱垂手术后办公室访视的比较:一项随机临床试验。

Video Virtual Clinical Encounters Versus Office Visits for Postoperative Care After Pelvic Organ Prolapse Surgery: A Randomized Clinical Trial.

机构信息

From the Division of Urogynecology, Department of Obstetrics and Gynecology, Kaiser Permanente, Northwest, Clackamas, OR.

Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA.

出版信息

Female Pelvic Med Reconstr Surg. 2021 Jul 1;27(7):432-438. doi: 10.1097/SPV.0000000000000909.

Abstract

OBJECTIVES

To determine if patient satisfaction of virtual clinical encounters is noninferior to traditional in-office clinical encounters for postoperative follow-up after reconstructive surgery for pelvic organ prolapse.

METHODS

This was a randomized controlled noninferiority trial of women undergoing surgery for pelvic organ prolapse. Women were recruited and randomized during their preoperative counseling visit to virtual clinical encounters via video conference technology or in-office clinical encounters for their 30-day postoperative follow-up visits. The primary outcome was patient satisfaction measured by the validated Patient Satisfaction Questionnaire-18 (score range, 18-90, with higher scores indicating greater satisfaction) administered by telephone following the 30-day visit. Additional information regarding demographics, postoperative health care utilization, and complications was collected via chart review and compared between groups.

RESULTS

A total of 52 women were randomly assigned to virtual clinical encounters via videoconference technology or traditional in-office clinical encounters (26 per group). The mean patient satisfaction score was 80.7 ± 2.6 in the virtual group and 81.2 ± 2.8 in the office group (difference, -0.46 points; 95% confidence interval, -1.95 to 1.03), which was consistent with noninferiority. Postoperative complication rates were 31% in the virtual group and 46% in the office group (P = 0.3). There were no significant between-group differences in secondary measures of unscheduled telephone calls (88% versus 77%, P = 0.5) and office visits (35% versus 38%, P = 0.8), emergency room visits (15% versus 19%, P = 1.0), and hospital readmissions (4% versus 12%, P = 0.6) within 90 days of surgery.

CONCLUSIONS

For patients with pelvic organ prolapse undergoing reconstructive surgery, postoperative virtual clinical encounters via video conference technology are noninferior to traditional in-office clinical encounters with high levels of short-term patient satisfaction and no differences in postoperative health care utilization and complications rates.

摘要

目的

确定虚拟临床访视在接受盆腔器官脱垂重建手术后的 30 天随访中是否不劣于传统的门诊临床访视。

方法

这是一项针对接受盆腔器官脱垂手术的女性的随机对照非劣效性试验。在术前咨询就诊期间,女性通过视频会议技术接受虚拟临床访视或门诊临床访视进行 30 天术后随访,随机分组。主要结局是通过电话在 30 天访视后使用经过验证的患者满意度问卷 -18(评分范围 18-90,得分越高表示满意度越高)进行评估的患者满意度。通过病历回顾收集人口统计学、术后医疗保健利用和并发症的其他信息,并在组间进行比较。

结果

共有 52 名女性通过视频会议技术被随机分配至虚拟临床访视组或传统门诊临床访视组(每组 26 名)。虚拟组患者满意度评分为 80.7 ± 2.6,门诊组为 81.2 ± 2.8(差异为-0.46 分;95%置信区间为-1.95 至 1.03),符合非劣效性标准。虚拟组术后并发症发生率为 31%,门诊组为 46%(P = 0.3)。两组在术后 90 天内的非计划性电话就诊(88%对 77%,P = 0.5)、门诊就诊(35%对 38%,P = 0.8)、急诊就诊(15%对 19%,P = 1.0)和住院再入院(4%对 12%,P = 0.6)方面无显著差异。

结论

对于接受盆腔器官脱垂重建手术的患者,通过视频会议技术进行的术后虚拟临床访视不劣于传统的门诊临床访视,具有较高的短期患者满意度,且在术后医疗保健利用和并发症发生率方面无差异。

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