"Let the patient decide" – Person-centered postoperative follow-up contacts, initiated via a phone app after day surgery: Secondary analysis of a randomized controlled trial. (January 2019)

• Record Type: Journal Article
• Authors: Dahlberg, Karuna; Jaensson, Maria; Nilsson, Ulrica
• Is Part Of: International journal of surgery. Volume 61(2019)
• Page Start: 33
• Page End: 37
• Publication Date: 2019-01
• Subjects: Ambulatory surgery -- Follow-up -- eHealth; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2018.11.022
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: Background: Patients undergoing day surgery are expected to manage their recovery on their own. Follow-up routines differ, but many patients have expressed a need for more professional support during recovery. The aim of this study was to describe how many follow-up contacts were initiated, and when and why, via a digital solution. Also, we wanted to compare postoperative recovery and characteristics between patients requesting, and patients not requesting, contact. Materials and methods: This was a secondary analysis of a multicenter, two-group, parallel randomized controlled trial. Participants used a digital solution called "Recovery Assessment by Phone Points (RAPP)" for initiating follow-up contacts after day surgery. The quality of postoperative recovery was measured with the Swedish web-version of Quality of Recovery. Results: Of 494 patients, 84 (17%) initiated contact via RAPP. The most common reasons for initiating contact were related to the surgical wound and pain. Contacts were initiated across the 14-day assessment period, with 62% (62/100) in the first postoperative week. The RAPP contact group had significantly poorer postoperative recovery on days 1– 14 compared to those not requesting contact via RAPP ( p < 0.001). There was a significantly higher proportion of patients who had undergone general anesthesia in the RAPP contact group (85% [71/84]) compared to the non-RAPP contact group (71% [291/410]), p = 0.003. Conclusion: Letting the patient decide him/herself whether, and when, contact and support is needed during the postoperative period, is possible and does not increase the frequency of contacts. This study investigates a digital solution, RAPP, as one example of a person-centered approach that can be implemented in day surgery follow-up. Highlights: Follow-up contacts were requested in 17% of cases during 14 days postoperatively. The most common reasons for contacts were related to the surgical wound and pain. Significantly poorer postoperative recovery was reported in the contact group. Whether follow-up contact is required, and when, can be decided by the patient.