Accepted for/Published in: JMIR Perioperative Medicine
Date Submitted: Oct 11, 2024
Date Accepted: Dec 15, 2024
Feasibility of a comprehensive eCoach to support patients undergoing colorectal surgery: an observational study
ABSTRACT
Background:
The mainstay of colorectal cancer care is surgical resection, which carries a significant risk of complications. Efforts to improve outcomes have recently focused on intensive multimodal prehabilitation programs to better prepare patients for surgery, which make the perioperative process even more complex and demanding for patients. Digital applications (eCoaches) seem promising tools to guide patients during their care journey. We developed a comprehensive eCoach to support, guide, and monitor patients undergoing elective colorectal surgery through all phases of the care pathway.
Objective:
The primary aim of this study was to determine its feasibility, in terms of recruitment rate, retention rate, and compliance. Also, usability and patient experience were examined.
Methods:
A single-center cohort study was conducted from April to September 2023 in a tertiary teaching hospital in the Netherlands. All elective colorectal surgery patients were offered an eCoach that provided preoperative coaching of the prehabilitation protocol, guidance by giving timely information, and remote monitoring of postoperative recovery and complications. Recruitment and retention rate, as well as compliance for each part of the care pathway were determined. Secondary, patient-reported usability measured by the USE-questionnaire and patient experiences were reported.
Results:
The recruitment rate for the eCoach was 74% (n=49). Main reasons for exclusion were digital illiteracy (n=10), not owning a smartphone (n=3), and the expected burden of use being too high (n=2). The retention rate was 82% (n=37). Median preoperative compliance with required actions in the app was 92% [87-95], and postoperative 100% [100-100]. Patient-reported usability was good and patient experiences were mostly positive, although several suggestions for improvement were reported.
Conclusions:
Our results demonstrate the feasibility of a comprehensive eCoach for guiding and monitoring patients undergoing colorectal surgery throughout the care pathway. Compliance was excellent for all phases of the care pathway and recruitment and retention rates were comparable to rates reported in the literature. The study findings provide valuable insights for the further development of the eCoach and highlight the potential of digital health applications in perioperative support. Clinical Trial: Not Applicable
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