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应用程序远程随访与传统减重手术后门诊随访等效:BELLA 初步试验。

Remote Follow-up with a Mobile Application Is Equal to Traditional Outpatient Follow-up After Bariatric Surgery: the BELLA Pilot Trial.

机构信息

Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

Department of Biomedical Informatics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

出版信息

Obes Surg. 2023 Jun;33(6):1702-1709. doi: 10.1007/s11695-023-06587-2. Epub 2023 Apr 21.

Abstract

PURPOSE

Medical follow-up after bariatric surgery is recommended. However, the compliance was poor. This study aimed to evaluate the feasibility of a smartphone-based fully remote follow-up (FU) program for patients after bariatric surgery.

METHODS

In the interventional group, patients were followed up using a smartphone application (app), through which questionnaires were sent regularly. Participants in the control group underwent standard FU at the outpatient clinic every three months. After 12 months, all the participants were evaluated at an outpatient clinic.

RESULTS

Between August 2020 and March 2021, 44 and 43 patients in the interventional and control groups, respectively, were included in the analysis after three patients were lost to FU, and three withdrew their informed consent because they wished for more personal contact with medical caregivers. After 12 months, total weight loss (TWL), %TWL, and percentage of excess weight loss (%EWL) did not differ between groups. There were no significant differences in the complication rates, including surgical complications, malnutrition, and micronutrition deficiency. The parameters of bioelectrical impedance analysis and quality of life did not differ between the groups. Vitamins and minerals in serum were similar in both groups except for calcium, which was significantly higher in the interventional group (2.52 mmol/L vs. 2.35 mmol/L, p = 0.038).

CONCLUSION

Fully remote FU with a smartphone application is at least as effective as traditional in-person FU in an outpatient clinic after bariatric surgery. Through remote FU, patients can save time and medical professionals may have more resources for patients with more severe problems.

摘要

目的

建议对减重手术后进行医学随访。然而,患者的依从性很差。本研究旨在评估一种基于智能手机的完全远程随访(FU)程序用于减重手术后患者的可行性。

方法

在干预组中,患者使用智能手机应用程序(app)进行随访,定期通过该应用程序发送问卷。对照组的参与者每三个月在门诊进行标准 FU。在 12 个月后,所有参与者都在门诊进行评估。

结果

2020 年 8 月至 2021 年 3 月,分别有 44 名和 43 名患者在干预组和对照组中纳入分析,随访中有 3 名患者失访,3 名患者因希望与医疗照护者有更多的个人接触而撤回知情同意。12 个月后,两组间总减重(TWL)、%TWL 和多余体重减轻百分比(%EWL)无显著差异。两组间的并发症发生率(包括手术并发症、营养不良和微量营养缺乏)无显著差异。两组间生物电阻抗分析和生活质量的参数无显著差异。两组间血清中的维生素和矿物质相似,除了钙,干预组显著更高(2.52mmol/L 比 2.35mmol/L,p=0.038)。

结论

使用智能手机应用程序进行完全远程 FU 至少与传统门诊 FU 一样有效,可用于减重手术后。通过远程 FU,患者可以节省时间,而医疗专业人员可能有更多资源用于处理更严重问题的患者。

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