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居家康复:一项评估使用移动应用程序减少结直肠手术后再入院的随机对照试验方案。

Home to Stay: A randomized controlled trial protocol to assess use of a mobile app to reduce readmissions following colorectal surgery.

机构信息

Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, Ontario, Canada.

Department of Surgery, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

Colorectal Dis. 2022 Dec;24(12):1616-1621. doi: 10.1111/codi.16312. Epub 2022 Sep 4.

Abstract

AIM

Patients undergoing colorectal surgery face high rates of emergency room visits and readmission to hospital. These unplanned hospital visits lead to both increased patient anxiety and health care costs. The aim of this study is to evaluate the use of mobile application to support patients undergoing colorectal surgery following discharge from hospital.

METHOD

This study is a randomized controlled trial in which the control group will receive standard follow-up care following discharge after surgery and the intervention group will receive standard follow-up care in addition to the mobile application. The primary outcome is the proportion of patients with unplanned hospital visits within 30 days of discharge. The secondary outcomes are patient-reported outcomes on validated scales evaluating their quality of recovery following discharge. A sample size of 670 subjects is planned. For the primary outcome, the control and intervention groups will be compared using a generalized linear model to account for clustering of patients within centres. For the secondary outcomes, the overall scores on the Quality of Recovery 15 and Patient Activation Measure will be analysed using a linear regression model.

RESULTS

It is expected that the results of this study will show that the mobile app will lead to significant improvements in unplanned hospital visits as well as improved quality of recovery for patients.

CONCLUSION

If the trial is successful, the mobile app can be easily adopted more widely into clinical practice to support patients at home following surgery.

摘要

目的

接受结直肠手术的患者急诊就诊和再次住院的比例较高。这些非计划性的医院就诊会增加患者的焦虑和医疗成本。本研究旨在评估移动应用程序在患者出院后接受结直肠手术后的使用情况。

方法

这是一项随机对照试验,对照组在手术后出院后将接受标准随访护理,干预组除了接受标准随访护理外,还将接受移动应用程序。主要结局是出院后 30 天内计划性就诊的患者比例。次要结局是使用经过验证的量表评估患者出院后恢复质量的患者报告结局。计划纳入 670 例受试者。对于主要结局,将使用广义线性模型比较对照组和干预组,以考虑中心内患者的聚类。对于次要结局,将使用线性回归模型分析 Quality of Recovery 15 和 Patient Activation Measure 的总分。

结果

预计该研究的结果将表明,移动应用程序将显著减少计划性就诊次数,并改善患者的恢复质量。

结论

如果试验成功,移动应用程序可以很容易地在更广泛的临床实践中采用,以在手术后支持患者在家中康复。

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