Division of General Surgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Division of General Surgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
J Surg Res. 2021 May;261:179-184. doi: 10.1016/j.jss.2020.12.005. Epub 2021 Jan 12.
Perioperative patient education and engagement are critical components of care in patients undergoing bariatric surgery, given the short length of stay and the requirements to adhere to various instructions. The use of patient engagement mobile technology may promote adherence to perioperative protocols and improve care by potentially identifying complications earlier and reducing associated health care costs.
We introduced a mobile app that provides bariatric patients with access to educational materials and the ability to report on their symptoms. Using the data from the app and linking the data to patient outcomes collected in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database, we examined the effects of the app on readmission, length of stay, visits to the emergency department (ED), and patient satisfaction.
A total of 505 patients were enrolled in the app between July 2017 and March 2019. Among them, 396 patients who met the inclusion criteria for the study were compared with 458 patients in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database who were not enrolled in the app for the same study period. While the use of the app was not associated with the rates of prolonged length of stay, ED visits, and readmission, patients who completed a survey at 30 d after discharge reported that the app helped them avoid phone calls to the hospital (48.5%) and ED visits (13.0%). Furthermore, 94.8% of these patients reported that they would recommend the app to other patients undergoing the same surgery.
Additional features, such as the ability for patients to directly communicate with the health care providers within the app, may be effective in decreasing unnecessary health care utilization.
鉴于减重手术患者的住院时间短，且需要遵守各种医嘱，围手术期患者教育和参与是此类患者护理的关键组成部分。使用患者参与移动技术可以促进对围手术期方案的遵守，并通过更早地识别并发症和降低相关医疗保健成本来改善护理。
我们引入了一款移动应用程序，为减重患者提供了访问教育材料和报告症状的功能。利用应用程序中的数据，并将数据与代谢和减重外科认证和质量改进计划数据库中收集的患者结果相关联，我们研究了该应用程序对再入院率、住院时间、急诊就诊次数和患者满意度的影响。
共有 505 名患者在 2017 年 7 月至 2019 年 3 月期间注册了该应用程序。其中，396 名符合研究纳入标准的患者与代谢和减重外科认证和质量改进计划数据库中未注册该应用程序的 458 名患者进行了比较，研究期间相同。虽然使用该应用程序与延长住院时间、急诊就诊次数和再入院率无关，但在出院后 30 天接受调查的患者中，有 48.5%的患者表示该应用程序帮助他们避免了给医院打电话，13.0%的患者避免了去急诊就诊。此外，94.8%的患者表示他们会向其他接受同种手术的患者推荐该应用程序。
应用程序中增加患者与医疗保健提供者直接沟通的功能可能会有效减少不必要的医疗保健利用。
