A telehealth intervention to increase patient preparedness for surgery: a randomized trial

Abstract

Introduction and hypothesis Methods to increase surgical preparedness in urogynecology are lacking. Our objective was to evaluate the impact of a preoperative provider-initiated telehealth call on surgical preparedness. Methods This was a multicenter randomized controlled trial. Women undergoing surgery for pelvic organ prolapse and/or stress urinary incontinence were randomized to either a telehealth call 3 (± 2) days before surgery plus usual preoperative counseling versus usual preoperative counseling alone. Our primary outcome was surgical preparedness, as measured by the Preoperative Prepardeness Questionnaire. The Modified Surgical Pain Scale, Pelvic Floor Distress Inventory-20, Patient Global Impressions of Improvement, Patient Global Impressions of Severity, Satisfaction with Decision Scale, Decision Regret Scale, and Clavien-Dindo scores were obtained at 4-8 weeks postoperatively and comparisons were made between groups. Results Mean telehealth call time was 11.1 ± 4.11 min. Women who received a preoperative telehealth call (n = 63) were significantly more prepared for surgery than those who received usual preoperative counseling alone (n = 69); 82.5 vs 59.4%, p < 0.01). A preoperative telehealth call was associated with greater understanding of surgical alternatives (77.8 vs 59.4%, p = 0.03), complications (69.8 vs 47.8%, p = 0.01), hospital-based catheter care (54 vs 34.8%, p = 0.04) and patient perception that nurses and doctors had spent enough time preparing them for their upcoming surgery (84.1 vs 60.9%, p < 0.01). At 4-8 weeks, no differences in postoperative and patient reported outcomes were observed between groups (all p > 0.05). Conclusions A short preoperative telehealth call improves patient preparedness for urogynecological surgery.

Patient Satisfaction With Telehealth Visits for New Patient Appointments for Pelvic Floor Disorders: A Randomized Trial of Telehealth Versus Standard In-Person Office Visits

“…The acceptability and safety of telehealth have been previously demonstrated for perioperative care in urogynecology with studies reporting promising patient outcomes for preoperative counseling 9,16 and postoperative care. 7,8,17 These studies have reported high patient satisfaction with telehealth, suggesting that patients find this an acceptable modality.…”

“…6 Within urogynecology, telehealth has been shown to have comparable outcomes to in-person visits for postoperative care 7,8 and preoperative surgical counseling. 9 The coronavirus disease 2019 (COVID-19) pandemic changed the way medical care is delivered, requiring health care providers to practice medicine in the face of masking and distancing restrictions. Amid this, telehealth emerged as an increasingly useful tool.…”

“…Data from other surgical subspecialties have further supported the use of telehealth for perioperative care 6 . Within urogynecology, telehealth has been shown to have comparable outcomes to in-person visits for postoperative care 7,8 and preoperative surgical counseling 9 …”

Healthcare Resource Utilization After Apical Prolapse Surgery in Women Who Received In-Office Versus Telephone-Only Preoperative Teaching

“…Our findings add to the literature on the utility of telephone visits in the Supplemental Digital Content UROGYNECOLOGY ORIGINAL RESEARCH n satisfaction and perceived surgical outcome among women undergoing reconstructive surgery, and vice versa. [1][2][3] In addition to discussing procedure risks, benefits, alternatives, and complications, health care professionals can influence patient preparedness for surgery through proper education of postoperative expectations, wound care, activity limitations, and surgical goals. 4 Although preoperative counseling has traditionally been conducted in-person in the office, there has been an increased use of telehealth modalities for preoperative counseling, as seen in nearly every aspect of gynecology.…”

Implementing telemedicine in urogynecology: A feasibility study

“…In the postoperative follow-up, telemedicine was equivalent to in-person visits with respect to clinical outcomes and was associated with reduced common patient complaints [ 13 – 16 ]. Preoperative counseling improved staff satisfaction and patient preparedness for procedures [ 17 , 18 ]. Therefore, telemedicine can be appropriate for urogynecological care, but more studies are required [ 19 ].…”