JMIR Publications

ABSTRACT

Background:

Patients commonly experience stress and anxiety, throughout the perioperative process, which can lead to increased complications both before and after surgery, impacting the overall recovery process. By effectively addressing and managing them, patients can achieve better health and well-being outcomes. One crucial aspect of managing stress and anxiety is providing education about the surgical procedure. Research suggests that the level of preoperative anxiety is inversely correlated with the amount of information patients receive about the surgery. However, a significant challenge lies in the limited availability of stress and anxiety relief support for patients before surgery. Face-to-face education sessions may not always be feasible due to resource constraints. To overcome this, digital health interventions offer a promising solution. They can empower patients and improve their overall surgical experience. Digital health interventions have already proven beneficial in informing patients about the potential benefits and risks of available treatment options. However, their current focus primarily centers on providing informative content, overlooking the significance of personalization and patient empowerment.

Objective:

The main objective of this study was to assess the viability of a digital health intervention known as the Adhera CARINAE Digital Health Program. This program is specifically designed to offer evidence-based and personalized stress- and anxiety-management techniques. It achieves this by utilizing a comprehensive digital ecosystem that incorporates wearable devices, mobile applications, and virtual reality technologies. The intervention program also makes use of advanced data-driven techniques to deliver tailored patient education and lifestyle support.

Methods:

From September 2021 to March 2022, we enrolled 74 patients undergoing surgery from 5 hospitals across 3 European countries. The surgeries under consideration included cardiopulmonary and coronary artery bypass surgeries, cardiac valve replacement, prostate or bladder cancer surgeries, hip and knee replacement, maxillofacial surgery, and scoliosis. Participants were randomly allocated to the intervention or control group. The control group received standard care, while the intervention group received standard care along with exposure to the digital health intervention program.

Results:

The intervention group shows more positive relationships between the psychological dimensions of self-efficacy, self-management and mental well-being, suggesting that CARINAE solution could have a positive effect and impact on the reduction of stress and negative emotions.

Conclusions:

Our results provide an important first step towards a deeper understanding of optimizing digital health solutions to support patients undergoing surgery and for potential applications in remote patient monitoring and communication. Clinical Trial: Trial was registered in ClinicalTrials.gov: NCT05184725.