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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
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Enhancing Quadruple Health Outcomes After Thoracic Surgery: Feasibility Pilot Randomized Controlled Trial Using

Mahesh Nagappa1, Yamini Subramani1, Homer Yang1

  • 1Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Lawson Health Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

JMIR Perioperative Medicine
|February 12, 2025
PubMed
Summary
This summary is machine-generated.

Digital home monitoring (DHM) shows feasibility for improving postoperative care after thoracic surgery. This approach reduced emergency department visits and complications, enhancing patient recovery and potentially lowering costs.

Keywords:
RCTcaregivers satisfactioncontinuity of caredigital home monitoringfeasibilityhealthcare provider satisfactionpatient carepatient satisfactionperioperative medicinepostoperative monitoringquadruple health outcomesquestionnaireremote monitorsurgical recoverythoracic surgery

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Area of Science:

  • Surgical Recovery
  • Digital Health
  • Postoperative Care

Background:

  • Post-hospital discharge recovery presents challenges, with complications and pain potentially leading to emergency department (ED) visits and readmissions.
  • Digital home monitoring (DHM) offers a potential improvement over standard methods for postoperative care.

Purpose of the Study:

  • To conduct a feasibility study for a randomized controlled trial (RCT) comparing DHM to standard care for patients undergoing thoracic surgical procedures.
  • To assess the effectiveness of DHM in improving postoperative outcomes and patient experience.

Main Methods:

  • A pilot 2-arm parallel-group RCT was conducted with adult patients undergoing thoracic surgery, randomized 1:1 to DHM or standard care.
  • Feasibility was determined by achieving >75% recruitment, protocol adherence, and data collection rates.
  • Secondary outcomes included ED visits, readmissions, complications, length of stay, opioid consumption, quality of recovery, and satisfaction.

Main Results:

  • All feasibility criteria were met, with recruitment at 87.9%.
  • The DHM group showed significantly fewer unplanned ED visits (2.7% vs. 20.5%; P=.02) and postoperative complications (20% vs. 47.5%; P=.01).
  • DHM also led to shorter hospital stays (4.0 vs. 6.9 days; P=.05) and improved quality of recovery scores (185.4 vs. 178.3; P<.001), with lower costs per case.

Conclusions:

  • This pilot RCT confirms the feasibility of a full-scale trial investigating DHM for postoperative thoracic surgery care.
  • DHM demonstrates promise in enhancing continuity of care and improving patient outcomes.
  • Further investigation into DHM's efficacy is warranted.