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Digital postoperative follow-up after colorectal resection: a multi-center preliminary qualitative study on a patient reporting and monitoring application

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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.

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Data collected during this study is available on request to the corresponding author.

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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.

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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.

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Correspondence to Albert Wolthuis.

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All of the authors have no conflict of interest related to the manuscript.

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The Informed Consent was collected through the application : entering the application gave the consent to use data from participants.

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All procedures were approved by the Medical Central Ethical Committee of University Hospitals of Leuven (S64437).

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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

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