In recent years, more and more health care–focused smartphone apps have been created, including apps that encourage healthy behaviours and managing chronic conditions. However, the potential impact of app-assisted postsurgical care has not been fully explored yet. In the study at hand, researchers compared quality of recovery and patient satisfaction between conventional in-person follow-up and smartphone app–assisted follow-up for patients following Enhanced Recovery After Surgery Society (ERAS) protocols. This randomized clinical trial showed that, compared to the conventional in-person follow-up, smartphone-app assisted monitoring led to improved quality of the recovery, without a decreased care satisfaction with.
This randomized clinical trial, conducted from June 2019 to April 2021, included women older than 18 years undergoing oncologic breast reconstruction or major gynaecologic oncology surgery following ERAS protocols with the care of 2 surgeons at an academic tertiary care center.1 Patients were randomized 1:1 to receive smartphone app–assisted follow-up (app group) or conventional in-person follow-up (control group). The app group used a surgeon-monitored app to record Quality of Recovery 15 (QoR15) scores, European Organisation for Research and Treatment of Cancer–selected adverse events, drain outputs, and surgical site photographs over 6 weeks. Patient satisfaction scores were assessed using validated Patient Satisfaction Questionnaire III (PSQ-III) subscales at 2 and 6 weeks postoperatively. The control also completed the QoR15 and PSQ-III questionnaires at these intervals. The primary outcomes were quality of recovery and patient satisfaction, as measured by the QoR15 and PSQ-III, respectively. Secondary outcomes were complications; surgeons’ contacts with patients, and surgeons’ perceptions of app-assisted care.
Of the 72 patients included in the trial, 36 underwent a breast reconstruction (mean age, 45.30 (SD=9.13) years) whereas the 36 remaining had gynaecologic oncology surgery (mean age, 54.90 (SD=11.18) years). Three patients dropped out; two who underwent breast reconstruction (one in the app group, one in the control group) and one who underwent gynaecologic oncology surgery (control group). The app group had significantly higher mean QoR15 scores than the control group (2 weeks: 127.58 (SD=22.03) vs 117.68 (SD=17.52), P = .02; 6 weeks: 136.64 (SD=17.53) vs 129.76 (SD=16.42), P = .03). Patients were equally satisfied between groups in all subsets of the PSQ-III at these intervals. The mean number of complications was similar in both groups, and a similar number of surgeon contacts per patient occurred (1.6 (SD=1.2) vs 2.1 (SD=2.0), P = .16). Surgeons appreciated early identification of complications with the app.
In this randomized clinical trial, postoperative follow-up with app–assisted monitoring led to an improved quality of recovery and an equal care satisfaction vs. conventional in-person follow-up in patients undergoing breast reconstruction or gynaecologic oncology surgery
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