A Qualitative Study of Electronic Patient-Reported Outcome Symptom Monitoring After Thoracic Surgery

Area of Science:

• Digital health
• Health services research
• Surgical outcomes

Background:

• Thoracic surgery recovery is often complex, with digital health systems offering potential for remote symptom management.
• Clinical adoption of electronic patient-reported outcome (ePRO) platforms for postoperative care faces persistent obstacles.
• This study investigated patient-identified barriers and facilitators to using an ePRO platform for monitoring thoracic surgery recovery.

Purpose of the Study:

• To identify patient-perceived barriers and facilitators to adopting an ePRO monitoring platform after thoracic surgery.
• To inform design and implementation improvements for ePRO systems in postoperative care.

Main Methods:

• Semistructured interviews were conducted with 16 patients post-thoracic surgery.
• Thematic content analysis and iterative team-based coding were used to analyze interview data.
• Themes were mapped to the Capability, Opportunity, and Motivation Model to guide ePRO improvements.

Main Results:

• Identified barriers included patient physical/mental health, technology access issues (internet, email), unclear clinical integration, and redundant symptom questions.
• Facilitators included ease of ePRO completion, engagement with the surgical team, and increased patient symptom awareness.
• Suggested improvements involved alternative completion methods, personalized assessments, and patient education on ePRO use.

Conclusions:

• Addressable barriers and facilitators to implementing ePRO symptom monitoring in thoracic surgery patients postdischarge were identified.
• Future research will evaluate design enhancements' impact on ePRO feasibility and acceptability.