Department of Surgery, Connolly Hospital, Royal College of Surgeons in Ireland, Dublin, Ireland.
Department of Surgery, Connolly Hospital, Royal College of Surgeons in Ireland, Dublin, Ireland.
J Surg Res. 2022 Dec;280:226-233. doi: 10.1016/j.jss.2022.07.013. Epub 2022 Aug 22.
Routine outpatient follow-up visits for surgical patients are a source of strain on health-care resources and patients. With the COVID-19 pandemic adding a new urgency to finding the safest follow-up arrangement, text message follow-up might prove an acceptable alternative to a phone call or an in-person clinic visit.
An open-label, three-arm, parallel randomized trial was conducted. The interventions were traditional in-person appointment, a telephone call, or a text message. The primary outcome was the number of postdischarge complications identified. The secondary outcomes were patient satisfaction with follow-up, future preference, default to follow-up, and preference to receiving medical information by text message.
Two hundred eight patients underwent randomization: 50 in the in-person group, 80 in the telephone group, and 78 in the text message group. There was no difference in the number of reported complications: 5 (10%) patients in the in-person group, 7 (9%) patients in the text group, and 11 (14%) patients in the telephone group (P = 0.613). The preferred method of follow-up was by telephone (106, 61.6%). The least preferred was the in-person follow-up (15, 8.7%, P = 0.002), which also had the highest default rate (44%).
There was no evidence that text messages and telephone calls are unsafe and ineffective methods of follow-up. Although most patients are happy to receive results by text message, the majority of patients would prefer a telephone follow-up and are less likely to default by this method. Health-care systems should develop telehealth initiatives when planning health-care services in the wake of the COVID-19 pandemic.
对手术患者进行常规门诊随访是医疗资源和患者的负担。随着 COVID-19 大流行对寻找最安全的随访安排的紧迫性增加，短信随访可能是电话或门诊就诊的一种可接受的替代方式。
进行了一项开放性、三臂、平行随机试验。干预措施为传统的门诊预约、电话或短信。主要结局是确定出院后并发症的数量。次要结局是患者对随访的满意度、未来偏好、随访违约以及通过短信接收医疗信息的偏好。
208 名患者接受了随机分组：50 名在门诊组，80 名在电话组，78 名在短信组。报告的并发症数量没有差异：门诊组 5 例（10%），短信组 7 例（9%），电话组 11 例（14%）（P=0.613）。首选的随访方式是电话（106 例，61.6%）。最不喜欢的是门诊随访（15 例，8.7%，P=0.002），它的违约率也最高（44%）。
没有证据表明短信和电话是不安全和无效的随访方式。尽管大多数患者乐于通过短信接收结果，但大多数患者更愿意通过电话进行随访，通过这种方式违约的可能性较小。在 COVID-19 大流行后，医疗保健系统在规划医疗服务时应制定远程医疗计划。
