Post-discharge follow-up using text messaging within an enhanced recovery program after colorectal surgery

Area of Science:

• Colorectal Surgery
• Surgical Recovery Programs
• Digital Health Monitoring

Background:

• Enhanced recovery after surgery (ERP) programs facilitate early patient discharge.
• Extended post-discharge surveillance is crucial for risk management.
• Text message (TM) surveillance has proven effective for minor surgeries.

Purpose of the Study:

• To assess the feasibility of home surveillance using text messages (TM) for patients undergoing colorectal surgery within an ERP.

Main Methods:

• Prospective multicenter study of 111 patients undergoing colorectal surgery within an ERP.
• Post-discharge TM surveillance on days 1, 3, and 5, querying pain, bowel function, temperature, and phlebitis.
• Automated alerts to physicians for abnormal responses or lack of response, triggering immediate patient contact.

Main Results:

• High TM response rate: 90% answered all messages within a median of 12 minutes.
• 48 alerts generated: 56% for pain, 40% for no response.
• 4% of patients required in-hospital care, including 3 re-hospitalizations and 2 unplanned re-operations.
• High patient satisfaction: median score of 5/5 (85% response rate).

Conclusions:

• Text message surveillance is a feasible approach for post-discharge home monitoring of colorectal surgery patients in ERPs.
• This method mirrors successful applications in ambulatory surgery.
• TM surveillance supports extended patient oversight and timely medical intervention.