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A personalised eHealth programme reduces the duration until return to work after gynaecological surgery: results of a
A Vonk Noordegraaf1, J R Anema, W van Mechelen
1Department of Obstetrics and Gynaecology, & EMGO Institute for Health and Care Research, AMC-UMCG-UWV-VUmc, Amsterdam, the Netherlands; Department of Public and Occupational Health, & EMGO Institute for Health and Care Research, AMC-UMCG-UWV-VUmc, Amsterdam, the Netherlands.
Objective:
To evaluate the effectiveness of an eHealth intervention on recovery and return to work, after gynaecological surgery.
Design:
Randomised multicentre trial that ran from March 2010 until September 2011.
Setting:
Secondary care in seven general and university hospitals in The Netherlands.
Population:
A cohort of 215 women (aged 18-65 years) who had a hysterectomy and/or laparoscopic adnexal surgery for a benign indication.
Methods:
The women were randomly assigned to the intervention group (n = 110) or the control group (n = 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.
Main Outcome Measures:
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.
Results:
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; P = 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; P = 0.035) and quality of life was higher (Rand-36 health survey, between-group difference 30, 95% confidence interval 4-57; P = 0.024) in the intervention group, compared with the control group.
Conclusions:
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.