A personalised eHealth programme reduces the duration until return to work after gynaecological surgery: results of a multicentre randomised trial. (11th February 2014)

• Record Type: Journal Article
• Authors: Vonk Noordegraaf, A; Anema, JR; van Mechelen, W; Knol, DL; van Baal, WM; van Kesteren, PJM; Brölmann, HAM; Huirne, JAF
• Is Part Of: BJOG. Volume 121:Number 9(2014:Sep.)
• Page Start: 1127
• Page End: 1136
• Publication Date: 2014-02-11
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.12661
• Languages: English
• ISSNs: 1470-0328

Abstract

<abstract abstract-type="main" id="bjo12661-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bjo12661-sec-0001" sec-type="section"> <title>Objective</title> <p>To evaluate the effectiveness of an eHealth intervention on recovery and return to work, after gynaecological surgery.</p> </sec> <sec id="bjo12661-sec-0002" sec-type="section"> <title>Design</title> <p>Randomised multicentre trial that ran from March 2010 until September 2011.</p> </sec> <sec id="bjo12661-sec-0003" sec-type="section"> <title>Setting</title> <p>Secondary care in seven general and university hospitals in the Netherlands.</p> </sec> <sec id="bjo12661-sec-0004" sec-type="section"> <title>Population</title> <p>A cohort of 215 women (aged 18–65 years) who had a hysterectomy and/or laparoscopic adnexal surgery for a benign indication.</p> </sec> <sec id="bjo12661-sec-0005" sec-type="section"> <title>Methods</title> <p>The women were randomly assigned to the intervention group (<italic>n</italic> = 110) or the control group (<italic>n</italic> = 105). The intervention group received an eHealth programme that provided personalised tailor‐made pre‐ and postoperative instructions on the resumption of daily activities, including work, and tools to improve self‐empowerment and to identify recovery problems. The control group was provided with access to a control website.</p> </sec> <sec id="bjo12661-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>The primary outcome was the duration of sick leave until a full sustainable return to work. Secondary outcome measures were quality of life, general recovery, and pain intensity.</p> </sec> <sec id="bjo12661-sec-0007" sec-type="section"> <title>Results</title> <p>In intention‐to‐treat analysis the eHealth intervention was effective on time to return to work (hazard ratio 1.43; 95% confidence interval 1.003–2.040; <italic>P </italic>= 0.048). The median duration of sick leave until a full sustainable return to work was 39 days (interquartile range 20–67 days) in the intervention group and 48 days (interquartile range 21–69 days) in the control group. After 26 weeks pain intensity was lower (visual analogue scale, cumulative odds ratio 1.84; 95% confidence interval 1.04–3.25; <italic>P </italic>= 0.035) and quality of life was higher (Rand‐36 health survey, between‐group difference 30, 95% confidence interval 4–57; <italic>P </italic>= 0.024) in the intervention group, compared with the control group.</p> </sec> <sec id="bjo12661-sec-0008" sec-type="section"> <title>Conclusions</title> <p>The use of the eHealth intervention by women after gynaecological surgery results in a faster return to work, with a higher quality of life and less pain.</p> </sec> </abstract>