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Enhancing Surgical Task Adherence Through a Rewards-Driven Mobile Application: A Single-Arm Intervention Feasibility

Pemla Jagtiani1, Paul G Mastrokostas1, Sean Inzerillo1

  • 1School of Medicine, State University of New York Downstate Health Sciences University, New York, USA.

Cureus
|June 24, 2024
PubMed
Summary

Financial incentives via an app improved adherence to preoperative surgical instructions. Postoperative adherence decreased, indicating a need for refined strategies to maintain patient engagement throughout recovery.

Keywords:
monetary incentivesneurosurgeryomnichannel communicationpostoperative instructionspreoperative adherence

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Area of Science:

  • Medical Informatics
  • Health Services Research
  • Surgical Patient Care

Background:

  • Patient adherence to preoperative and postoperative instructions is critical for surgical success.
  • This pilot study explored using monetary incentives via an app-based omnichannel communication model to improve adherence.

Purpose of the Study:

  • To investigate the feasibility of using financial incentives through a nudge engine application to enhance patient adherence to surgical instructions.
  • To assess the effectiveness of app-based incentives in prompting preoperative and postoperative task completion.

Main Methods:

  • A six-month longitudinal study was conducted using the TheraPay Rewards app at Maimonides Medical Center.
  • Participants (n=16) received $15 gift card credits for completing validated preoperative and postoperative tasks.
  • Recruitment targeted English and Spanish-speaking patients with smartphones.

Main Results:

  • Preoperative task completion rates ranged from 83% to 100%, with an average adherence of 98.7%.
  • Postoperative task completion rates varied from 20% to 100%, with an average adherence of 60%.
  • The majority of participants were male (62.5%) with a mean age of 59.5 years.

Conclusions:

  • Financial incentives delivered via a gamified app effectively encourage preoperative task adherence.
  • The observed decrease in postoperative adherence necessitates careful implementation strategies for sustained engagement.
  • Future research should compare cancellation rates and outcomes to evaluate the impact of app-based incentives on surgical results.