Use of a web-based app to improve postoperative outcomes for patients receiving gynecological oncology care

A randomized controlled feasibility trial

Ilana Yonas, Janeane N. Anderson, Caitlin N. McKillop, Edward J. Stepanski, Andrew J. Paladino, Todd Tillmanns

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: Nearly 1 in 5 patients hospitalized for ovarian cancer surgery are readmitted for complications that may have been prevented with monitoring. We conducted a randomized controlled feasibility trial to evaluate a postoperative web-based app intervention to provide real-time symptom monitoring among patients diagnosed or with suspected gynecological cancer who had open bilateral salpingo-oophorectomy surgery. Methods: Participants were randomized into two groups: (1) App + Reminder: had access to the app, and use was encouraged with daily and/or weekly reminders; (2) app: had access to the app but received no reminders. The app displayed discharge instructions and queried symptoms. Patients’ self-reported health information was integrated into their electronic health records. Outcomes above a predetermined threshold triggered alerts that indicated a patient may need medical intervention. Participants completed a questionnaire at baseline and 30-day follow-up. They were also invited to provide qualitative, post-intervention feedback. Results: We screened 35 patients, with high rates of recruitment (74%, N = 26) and completion (93%, N = 24). Participants in the App + Reminder group had more frequent app use relative to the app group (p = 0.05). Using differences-in-differences (DID) analysis for quality of life, the App + Reminder group had relative increase in the mental health score (DID = 7.51, p = 0.15) but decrease in the physical health score (DID = −7.49, p = 0.13). Participant feedback suggested the relative decrease in physical quality of life was attributable to the app activating patients’ focus on physical symptoms, not the intervention. Conclusion: The pilot established feasibility, acceptability, and some potential benefits of a new web-based app intervention for gynecological oncology postoperative care.

Original languageEnglish (US)
Pages (from-to)311-317
Number of pages7
JournalGynecologic oncology
Volume150
Issue number2
DOIs
StatePublished - Aug 1 2018

Fingerprint

Randomized Controlled Trials
Quality of Life
Postoperative Care
Electronic Health Records
Health
Physiologic Monitoring
Ovariectomy
Ovarian Neoplasms
Mental Health
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynecology

Cite this

Use of a web-based app to improve postoperative outcomes for patients receiving gynecological oncology care : A randomized controlled feasibility trial. / Yonas, Ilana; Anderson, Janeane N.; McKillop, Caitlin N.; Stepanski, Edward J.; Paladino, Andrew J.; Tillmanns, Todd.

In: Gynecologic oncology, Vol. 150, No. 2, 01.08.2018, p. 311-317.

Research output: Contribution to journalArticle

Yonas, Ilana ; Anderson, Janeane N. ; McKillop, Caitlin N. ; Stepanski, Edward J. ; Paladino, Andrew J. ; Tillmanns, Todd. / Use of a web-based app to improve postoperative outcomes for patients receiving gynecological oncology care : A randomized controlled feasibility trial. In: Gynecologic oncology. 2018 ; Vol. 150, No. 2. pp. 311-317.
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abstract = "Objective: Nearly 1 in 5 patients hospitalized for ovarian cancer surgery are readmitted for complications that may have been prevented with monitoring. We conducted a randomized controlled feasibility trial to evaluate a postoperative web-based app intervention to provide real-time symptom monitoring among patients diagnosed or with suspected gynecological cancer who had open bilateral salpingo-oophorectomy surgery. Methods: Participants were randomized into two groups: (1) App + Reminder: had access to the app, and use was encouraged with daily and/or weekly reminders; (2) app: had access to the app but received no reminders. The app displayed discharge instructions and queried symptoms. Patients’ self-reported health information was integrated into their electronic health records. Outcomes above a predetermined threshold triggered alerts that indicated a patient may need medical intervention. Participants completed a questionnaire at baseline and 30-day follow-up. They were also invited to provide qualitative, post-intervention feedback. Results: We screened 35 patients, with high rates of recruitment (74{\%}, N = 26) and completion (93{\%}, N = 24). Participants in the App + Reminder group had more frequent app use relative to the app group (p = 0.05). Using differences-in-differences (DID) analysis for quality of life, the App + Reminder group had relative increase in the mental health score (DID = 7.51, p = 0.15) but decrease in the physical health score (DID = −7.49, p = 0.13). Participant feedback suggested the relative decrease in physical quality of life was attributable to the app activating patients’ focus on physical symptoms, not the intervention. Conclusion: The pilot established feasibility, acceptability, and some potential benefits of a new web-based app intervention for gynecological oncology postoperative care.",
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