Electronic patient-reported symptom monitoring in patients recovering from ambulatory minimally invasive gynecologic surgery: A prospective pilot study

Abstract

Objective To evaluate the feasibility of an electronic symptom-tracking platform for patients recovering from ambulatory surgery. Method We assessed user response to an electronic system designed to self-report symptoms. Endpoints included compliance, postoperative symptoms, patient satisfaction. An 8-item symptom inventory (pain, nausea, vomiting, shortness of breath, fever, swelling, discharge, redness) was developed and made available on postoperative days (POD) 2–6. Responses exceeding defined thresholds of severity triggered alerts to healthcare providers. Symptoms, alerts, actions taken, urgent care center (UCC) visits, hospital admissions were tracked until POD 30. Patient satisfaction was evaluated on POD 7. A patient was defined as “responder” if at least 5/8 items on at least 3 PODs were completed. The assessment method was deemed successful if 64/100 patients responded. Results 97/102 patients were evaluable; 65 met “responder” criteria (67% responder rate; 95% CI 57–76%). 321 surveys were completed (median 4/patient), 248 (77%) in ≤2 min. Involving caregivers and allowing additional symptom-reporting improved the responder rate to 72% (95% CI 58–84%). Most commonly-reported moderate, severe, very severe symptoms were pain, nausea, swelling; 71% reported moderate to very severe pain on POD 2. Phone calls and adjustment of medications adequately addressed most symptoms. Two patients (2%) presented at UCC before, 6 (6%) after, POD 6; 1 (1%) was admitted. Most agreed or strongly agreed that electronic symptom-tracking was helpful, easy to use, and would recommend it to others. Conclusion Electronic symptom-tracking is feasible for patients undergoing ambulatory gynecologic cancer surgery. Symptom burden is high in the early postoperative period. Addressing patient-reported symptoms in a timely, automated manner may prevent severe downstream adverse events, reduce UCC visits and admission rates, and improve outcomes.

Discharge teaching, patient-reported discharge readiness and postsurgical outcomes in gynecologic patients undergoing day surgery: a generalized estimating equation

“…Most patient-reported problems after minimally invasive gynecologic surgery include pain, vaginal bleeding, urinary tract infection and surgical site infection [ 26 – 28 ]. This study showed that the most common postsurgical problems of minimally invasive gynecologic surgery were vaginal bleeding, followed by mild pain.…”

“…To verify the correlations between the three variables, three telephone interviews were conducted with patients to investigate these postsurgical outcomes. Most patient-reported problems after day gynecologic surgery include constipation, diarrhea, pain, vaginal bleeding, urinary tract infection and surgical site infection [ 26 – 28 ]. In this study, we included these problems on our postsurgical outcomes form.…”

Manajemen Gejala Kanker Jarak Jauh Berbasis Mobile Phone pada Pasien Kanker Ginekologi : Tinjauan Literatur

“…Manfaat lainnya pada pasien kanker ginekologi yaitu sangat layak dalam melacak pasien yang telah melakukan operasi ginekologi (Hay et al, 2016). Dengan adanya pelaporan gejala secara langsung tanpa adanya perspektif dari oranglain, gejala psikologis ikut menjadi perhatian sejalan dengan mengatasi gejala fisik (Zivanovic et al, 2020). Tinjauan pustaka ini mungkin saja menjadi yang pertama dalam mengeksloprasi manajemen gejala kanker jarak jauh pada pasien kanker ginekologi.…”

“I was never one of those people who just jumped right in for me”: patient perspectives on self-advocacy training for women with advanced cancer

“…The current lack of theoretically based interventions to teach self-advocacy skills [ 10 , 11 ] prevents patients with low self-advocacy skills from effectively engaging in their care and puts them at risk for poor outcomes such as poor symptom management, low quality of life, and lack of patient-centered care [ 13 , 14 ]. This is particularly true for individuals who are newly diagnosed with cancer when treatment decisions are often complex, cancer- and treatment-related symptoms and have a huge impact on quality of life and managing social support can be challenging.…”