Kneuertz Peter J, Jagadesh Niveditha, Perkins Alicia, Fitzgerald Morgan, Moffatt-Bruce Susan D, Merritt Robert E, D'Souza Desmond M
Division of Thoracic Surgery, Department of Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA.
J Thorac Dis. 2020 Nov;12(11):6883-6891. doi: 10.21037/jtd.2020.01.23.
Active patient engagement may improve their perioperative experience and outcomes. We sought to evaluate the use of a mobile device application (App) for patient engagement and patient reported outcomes (PROs) assessment following robotic lung cancer surgery.
Patients with suspected lung cancer undergoing robotic resection between January-May 2019, were offered the SeamlessMD App, which was customized to meet requirements of the thoracic enhanced recovery pathway. The App guided patients through preoperative preparation, in-hospital recovery, and post-op discharge care with personalized reminders, task lists, education, progress tracking, and surveys.
Fifty patients participated in the study (22.1%). Of the 50 patients, 20 (40%) patients completed the preoperative compliance survey, and 31 (62%) completed the hospital satisfaction survey. A total of 62 inpatient recovery checks were completed, identifying non-compliance with incentive spirometer use in 2 (3.2%) and patient worries about self-care after discharge in 18 (29%) instances. Postoperative health-checks were completed by 27 (54%) patients with a median of 3 [0-17] completed surveys per patient. Patient reported symptom scores up to 30 days after surgery, demonstrating a significant decrease maximum pain level (P=0.002) and anxiety scores (P<0.001). The App enabled health-checks improved confidence and decreased worries in over 80% of patients. Nine patients (40.9%) reported the health-checks helped avoid 1+ calls and 4 (18.2%) reported the App helped avoid 1+ visits to the hospital. Over 74% of patients reported the App was very or extremely useful in each of the preoperative, inpatient, and post-discharge settings.
A mobile device platform may serve as an effective mechanism to record perioperative PROs and satisfaction while facilitating patient-provider engagement in perioperative care.
患者的积极参与可能会改善其围手术期体验及预后。我们旨在评估一款移动设备应用程序（App）在机器人辅助肺癌手术后促进患者参与及评估患者报告结局（PROs）方面的应用情况。
2019年1月至5月期间接受机器人辅助切除术的疑似肺癌患者被提供了SeamlessMD App，该应用程序是根据胸部强化康复路径的要求定制的。该应用程序通过个性化提醒、任务列表、教育、进展跟踪和调查，指导患者进行术前准备、住院康复和术后出院护理。
50名患者参与了研究（22.1%）。在这50名患者中，20名（40%）患者完成了术前依从性调查，31名（62%）患者完成了医院满意度调查。共完成了62次住院康复检查，发现2例（3.2%）未按要求使用激励肺活量计，18例（29%）患者出院后担心自我护理。27名（54%）患者完成了术后健康检查，每位患者完成调查的中位数为3次[0 - 17次]。患者报告了术后30天内的症状评分，结果显示最大疼痛水平（P = 0.002）和焦虑评分（P < 0.001）显著降低。该应用程序进行的健康检查使超过80%的患者信心增强且担忧减少。9名患者（40.9%）报告健康检查帮助避免了1次及以上电话咨询，4名患者（18.2%）报告该应用程序帮助避免了1次及以上医院就诊。超过74%的患者报告该应用程序在术前、住院期间和出院后各个阶段都非常或极其有用。
移动设备平台可作为记录围手术期PROs和满意度的有效机制，同时促进患者与医护人员在围手术期护理中的互动。
