Abstract
The development of minimally invasive colorectal surgery in the last decades led to a decrease in length of hospital stay. However, readmission and postoperative complications were still observed. Several studies have shown that close postoperative follow-up is required to decrease postoperative morbidity through patient education and by detecting early signs of complications. To help in this task, multiple monitoring programs have been set up to follow patients at home, allowing detection of several complications at an early stage. To evaluate acceptance, satisfaction, usability, compliance and safety of a mobile application following postoperative colorectal patients during the first 15 days post-discharge from hospital. A mobile application enabling the communication between the patient and medical staff during the recovery phase was developed and tested in four hospitals. Patients who underwent a colorectal resection were included in this prospective qualitative study. Questionnaires to assess satisfaction and usability were handed out to patients at the end of the test period. Overall, 118 patients (52% females, median age 52.5 years) were included. Median adherence-rate during 15 days was 89.6%. Satisfaction-rate for the application was 76% and usability was high. Overall, 1220 notifications were collected, of which 722 were orange, 466 red and 32 purple, colours used to rate the severeness of complaints. We analyzed the most common notifications, showing trends in different subgroups of the study with higher risks of complications (pain (409 notifications), abnormal stools (196 notifications), and wound problems (118 notifications)). A mobile application could be used to follow patients at home after colorectal resection. Future studies should evaluate whether these applications can detect complications and prevent readmission.
Similar content being viewed by others
Data availability
Data collected during this study is available on request to the corresponding author.
References
Lee L, Eustache J, Tran-McCaslin M, Basam M, Baldini G, Rudikoff AG, Liberman S, Feldman LS, McLemore EC (2022) North American multicentre evaluation of a same-day discharge protocol for minimally invasive colorectal surgery using mHealth or telephone remote post-discharge monitoring. Surg Endosc. https://doi.org/10.1007/s00464-022-09208-8
Oates EV, Lim G, Nevins EJ, Kanakala V (2021) Are surgical patients satisfied with remote consultations? A comparison of remote versus conventional outpatient clinic follow-up for surgical patients: a systematic review and meta-analysis of randomized controlled trials. Journal of patient experience 8:23743735211035916. https://doi.org/10.1177/23743735211035916
Tevis SE, Kennedy GD (2016) Postoperative complications : looking forward to a safer future. Clin Colon Rectal Surg 29(3):246–252. https://doi.org/10.1055/s-0036-1584501
Keng C, Goriawala A, Rashid S, Goldstein R, Schmocker S, Easson A, Kennedy E (2020) Home to stay: an integrated monitoring system using a mobile app to support patients at home following colorectal surgery. J Patient Exp 7(6):1241–1246. https://doi.org/10.1177/2374373520904194
Li LT, Mills WL, White DL, Li A, Gutierrez AM, Berger DH, Naik AD (2013) Causes and prevalence of unplanned readmissions after colorectal surgery: a systematic review and meta-analysis. J Am Geriatr Soc 61(7):1175–1181. https://doi.org/10.1111/jgs.12307
VC Nikolian, AM Williams, BN Jacobs, MT Kemp, JK Wilson, MW Mulholland, HB Alam (2018) Pilot study to evaluate the safety, feasibility, and financial implications of a postoperative telemedicine program. Ann Surg 268(4): 700–707. https://doi.org/10.1097/SLA.0000000000002931
Miller M, Roxburgh CS, McCann L, Connaghan J, Van-Wyk H, McSorley S, Maguire R (2020) Development of a remote monitoring application to improve care and support patients in the first 30 days following colorectal cancer surgery. Semin Oncol Nurs 36(6):151086. https://doi.org/10.1016/j.soncn.2020.151086
Semple JL, Sharpe S, Murnaghan ML, Theodoropoulos J, Metcalfe KA (2015) Using a mobile app for monitoring post-operative quality of recovery of patients at home: a feasibility study. JMIR MHealth Uhealth 3(1):e18. https://doi.org/10.2196/mhealth.3929
Mancini R, Bartolo M, Pattaro G, Ioni L, Picconi T, Pernazza G, “A.O. San Giovanni – Addolorata”, Rome, (2022) The role of telemedicine in the postoperative home monitoring after robotic colo-rectal cancer surgery: a preliminary single center experience. Updat Surg 74(1):171–178. https://doi.org/10.1007/s13304-021-01132-1
Ashraf H, Anderson RG, Anderson DJ, Moug SJ (2021) Feasibility of a perioperative smartphone application in colorectal surgery. Br J Surg 108(9):e282–e283. https://doi.org/10.1093/bjs/znab143
Salmani H, Nahvijou A, Sheikhtaheri A (2022) Smartphone-based application for self-management of patients with colorectal cancer: development and usability evaluation. Support Care Cancer 30(4):3249–3258. https://doi.org/10.1007/s00520-021-06754-0
Buller DB, Berwick M, Shane J, Kane I, Lantz K, Buller MK (2013) User-centered development of a smart phone mobile application delivering personalized real-time advice on sun protection. Transl Behav Med 3(3):326–334. https://doi.org/10.1007/s13142-013-0208-1
Chomutare T, Tatara N, Årsand E, Hartvigsen G (2013) Designing a diabetes mobile application with social network support. Stud Health Technol Inform 188:58–64
Schlund D, Poirier J, Bhama AR, Hayden D, Saclarides T, Orkin B, Favuzza J (2020) Value of an interactive phone application in an established enhanced recovery program. Int J Colorectal Dis 35(6):1045–1048. https://doi.org/10.1007/s00384-020-03563-5
O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA (2014) Standards for reporting qualitative research: a synthesis of recommendations. Acad Med 89(9):1245–1251
Acknowledgements
We would like to thank de Decker Guillaume, Wagelmans Elisa & Dr. Grange Philippe of Johnson & Johnson Medical Technologies and Vissers Filip of Q1.6 for supporting this study by providing the companies’ advanced digital technology. No representatives of Johnson & Johnson Surgical Technologies or Q1.6 had any role in the establishment of the study design, data collection, management, analysis, data interpretation, preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Author information
Authors and Affiliations
Contributions
Data curation: AW, J-PM, NAO, BVG. Formal analysis: SB. Supervision: AW. Validation: J-PM, BVG, NAO, GB, ADH, AW. Writing – Original draft: SB. Writing – Review and editing: J-PM, BVG, NAO, GB, AD’H, AW.
Corresponding author
Ethics declarations
Conflict of interest
All of the authors have no conflict of interest related to the manuscript.
Informed consent
The Informed Consent was collected through the application : entering the application gave the consent to use data from participants.
Human participants and/or animals
All procedures were approved by the Medical Central Ethical Committee of University Hospitals of Leuven (S64437).
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Bertoni, S., M.m.K. Magema, JP., Van Geluwe, B. et al. Digital postoperative follow-up after colorectal resection: a multi-center preliminary qualitative study on a patient reporting and monitoring application. Updates Surg 76, 139–146 (2024). https://doi.org/10.1007/s13304-023-01671-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13304-023-01671-9