• Annals of surgery · May 2023

    Randomized Controlled Trial

    Home to Stay: A Randomized Controlled Trial Evaluating the Effect of a Post-discharge Mobile App to Reduce 30-Day Re-admission Following Elective Colorectal Surgery.

    • Aman Pooni, Mantaj S Brar, Tharani Anpalagan, Selina Schmocker, Saira Rashid, Rachel Goldstein, Alifiya Goriawala, Alexandra Easson, and Erin D Kennedy.
    • Department of Surgery, University of Toronto, Toronto, ON, Canada.
    • Ann. Surg. 2023 May 1; 277 (5): e1056e1062e1056-e1062.

    ObjectiveA randomized controlled trial was conducted to evaluate the effect of a postdischarge app on 30-day readmissions and patient-reported outcomes following colorectal surgery.BackgroundPatients undergoing colorectal surgery are particularly vulnerable during their transition from hospital-to-home. There has been increasing interest in e-health to provide cost-effective transitional care. An integrated discharge monitoring program using a mobile app platform was developed to support patients after surgery.MethodsA 2 arm, superiority randomized control trial was conducted at an academic tertiary care center with patients undergoing elective colorectal surgery. The intervention group received usual postoperative care and postdischarge monitoring with the app. The primary outcome was 30-day readmissions following hospital discharge.ResultsTwo hundred eighty-two participants were randomized. The majority were young, had inflammatory bowel disease and underwent laparoscopic surgery. Intention to treat analysis showed no difference between groups for 30-day readmission (14.8% vs 17.6%, P =0.55), ER visits (25.0% vs 28.8%, P =0.49), primary care visits (12.5% vs 8.8%, P =0.34) or unplanned healthcare visits (34.4% vs 35.2%, P =0.89). All patient reported outcomes were significantly improved with median scores higher with the app for satisfaction [9, interquartile range (IQR): 8-10 vs 8, IQR: 7-9, P =0.001], well-being (7, IQR: 6-8 vs 6, IQR: 5-7, P =0.001) and significantly lower for anxiety (3, IQR: 2-5 vs 5, IQR: 3-6, P =0.001).ConclusionsAlthough the app did not show a significant reduction in 30-day readmission or ER visits, it did lead to significant improvements in patient-reported outcomes. The app may be an important tool to support patients following colorectal surgery.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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