Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
Department of Psychology and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA.
Neurosurgery. 2023 Mar 1;92(3):538-546. doi: 10.1227/neu.0000000000002245. Epub 2022 Nov 22.
Rapid growth in smartphone use has expanded opportunities to use mobile health (mHealth) technology to collect real-time patient-reported and objective biometric data. These data may have important implication for personalized treatments of degenerative spine disease. However, no large-scale study has examined the feasibility and acceptability of these methods in spine surgery patients.
To evaluate the feasibility and acceptability of a multimodal preoperative mHealth assessment in patients with degenerative spine disease.
Adults undergoing elective spine surgery were provided with Fitbit trackers and sent preoperative ecological momentary assessments (EMAs) assessing pain, disability, mood, and catastrophizing 5 times daily for 3 weeks. Objective adherence rates and a subjective acceptability survey were used to evaluate feasibility of these methods.
The 77 included participants completed an average of 82 EMAs each, with an average completion rate of 86%. Younger age and chronic pulmonary disease were significantly associated with lower EMA adherence. Seventy-two (93%) participants completed Fitbit monitoring and wore the Fitbits for an average of 247 hours each. On average, participants wore the Fitbits for at least 12 hours per day for 15 days. Only worse mood scores were independently associated with lower Fitbit adherence. Most participants endorsed positive experiences with the study protocol, including 91% who said they would be willing to complete EMAs to improve their preoperative surgical guidance.
Spine fusion candidates successfully completed a preoperative multimodal mHealth assessment with high acceptability. The intensive longitudinal data collected may provide new insights that improve patient selection and treatment guidance.
智能手机的快速普及为使用移动医疗（mHealth）技术实时收集患者报告的主观数据和客观生物计量数据提供了更多机会。这些数据可能对退行性脊柱疾病的个性化治疗具有重要意义。然而，目前还没有大规模的研究来检验这些方法在脊柱外科患者中的可行性和可接受性。
评估多模态术前 mHealth 评估在退行性脊柱疾病患者中的可行性和可接受性。
接受择期脊柱手术的成年人被提供 Fitbit 追踪器，并在术前 3 周内每天 5 次发送评估疼痛、残疾、情绪和灾难化的生态瞬时评估（EMA）。使用客观的依从率和主观的可接受性调查来评估这些方法的可行性。
77 名纳入的参与者平均完成了 82 次 EMA，平均完成率为 86%。年龄较小和慢性肺部疾病与 EMA 依从性较低显著相关。72 名（93%）参与者完成了 Fitbit 监测，平均佩戴 Fitbit 时间为 247 小时。平均而言，参与者每天佩戴 Fitbit 的时间至少为 12 小时，持续 15 天。只有更差的情绪评分与较低的 Fitbit 依从性独立相关。大多数参与者对研究方案表示积极的体验，包括 91%的人表示愿意完成 EMA 以改善术前手术指导。
脊柱融合候选者成功完成了术前多模态 mHealth 评估，具有较高的可接受性。收集的密集纵向数据可能会提供新的见解，以改善患者选择和治疗指导。
