Interactive online informational and peer support application for patients with low anterior resection syndrome: patient survey and protocol for a multicentre randomized controlled trial

Moon, Jeongyoon; Monton, Olivia; Smith, Alexis; Garfinkle, Richard; Zhao, Kaiqiong; Zelkowitz, Phyllis; Loiselle, Carmen G.; Fiore, Julio F.; Liberman, Alexander; Morin, Nancy; Faria, Julio; Ghitulescu, Gabriela; Vasilevsky, Carol‐Ann; Bhatnagar, Sahir; Boutros, Marylise

doi:10.1111/codi.15602

Cited by 12 publications

(8 citation statements)

References 22 publications

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“…Moreover, apps that collect and/or process medical data must comply with data privacy regulations [59,60] Specific standards needs to be followed, but not all app manufacturers are familiar with them [61]. Most of the included apps collect or process patient data (25/29), however, only three have mentioned privacy measures [30,48,50]. This does not have to imply that these apps do not comply with data privacy regulations as the development process was generally obscurely described.…”

Section: Discussionmentioning

confidence: 99%

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Mobile applications in gastrointestinal surgery: a systematic review

et al. 2023

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Background Mobile applications can facilitate or improve gastrointestinal surgical care by benefiting patients, healthcare providers, or both. The extent to which applications are currently in use in gastrointestinal surgical care is largely unknown, as reported in literature. This systematic review was conducted to provide an overview of the available gastrointestinal surgical applications and evaluate their prospects for surgical care provision. Methods The PubMed, EMBASE and Cochrane databases were searched for articles up to October 6th 2022. Articles were considered eligible if they assessed or described mobile applications used in a gastrointestinal surgery setting for healthcare purposes. Two authors independently evaluated selected studies and extracted data for analysis. Descriptive data analysis was conducted. The revised Cochrane risk of bias (RoB-2) tool and ROBINS-I assessment tool were used to determine the methodological quality of studies. Results Thirty-eight articles describing twenty-nine applications were included. The applications were classified into seven categories: monitoring, weight loss, postoperative recovery, education, communication, prognosis, and clinical decision-making. Most applications were reported for colorectal surgery, half of which focused on monitoring. Overall, a low-quality evidence was found. Most applications have only been evaluated on their usability or feasibility but not on the proposed clinical benefits. Studies with high quality evidence were identified in the areas of colorectal (2), hepatopancreatobiliary (1) and bariatric surgery (1), reporting significantly positive outcomes in terms of postoperative recovery, complications and weight loss. Conclusions The interest for applications and their use in gastrointestinal surgery is increasing. From our study, it appears that most studies using applications fail to report adequate clinical evaluation, and do not provide evidence on the effectiveness or safety of applications. Clinical evaluation of objective outcomes is much needed to evaluate the efficacy, quality and safety of applications being used as a medical device across user groups and settings.

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Section: Discussionmentioning

confidence: 99%

“…Although significant differences in BMI were reported between the intervention and the control group, the weight loss towards the preoperative weight was not analyzed. [50]. The app consisted of information modules and a peer support forum in which patients could communicate with mentors monitored by a team of HCP's.…”

Section: Communicationmentioning

confidence: 99%

Mobile applications in gastrointestinal surgery: a systematic review

et al. 2023

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“…The qualitative results support the use of this intervention in future studies. This pilot project led to the development of a multicentre randomized controlled trial ( N = 128) aimed at exploring the extent to which an interactive online information and peer support app for LARS affects quality of life in rectal cancer survivors (#NCT04469426) [30]. Based on user feedback, we have made several changes to the application to increase its utility and ease of use, including the ability to customize usernames and reorganization of the Patient Forum to facilitate easier discussion.…”

Section: Discussionmentioning

confidence: 99%

An online educational and supportive care application for rectal cancer survivors with low anterior resection syndrome: A mixed methods pilot study

Olivia,

Allister,

Jeongyoon

et al. 2023

Colorectal Disease

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AimRestorative proctectomy is commonly associated with significant bowel dysfunction, known as low anterior resection syndrome (LARS), which has a negative impact on patients' quality of life. We developed an online patient‐centred application on LARS (eLARS) for rectal cancer survivors. The primary objective of this study was to assess the feasibility of eLARS for rectal cancer survivors with LARS following restorative proctectomy. The secondary objective was to explore participants' experiences with LARS and the eLARS application.MethodsThis was a mixed methods study, which included a feasibility and qualitative analysis. Participants were rectal cancer survivors who underwent restorative proctectomy for rectal cancer within 3 years, completed all adjuvant treatment, and suffered from bowel dysfunction postoperatively. Participants were given access to the application over a 2‐month study period. Feasibility was defined as 75% of study participants using the application ≥4 times per month. Semi‐structured interviews were conducted with participants after the study period and were analysed using thematic analysis.ResultsOur sample included eight rectal cancer survivors, five women and three men. The median age was 58.5 years (56.5–64.5). Most participants (75%) were >1‐year post‐restorative proctectomy. 75% of study participants used the application ≥4 times per month for 2 months. Our thematic analysis revealed that participants felt that they lacked access to credible information and emotional support around the time of ileostomy closure, and found that eLARS addressed these challenges.ConclusioneLARS is a feasible educational and supportive care intervention for patients with LARS and has the potential to improve patients' quality of life.

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“…The resection of the rectum, division of the coccygeus muscle, and/or damage to the nerve supply can impair rectal function. The remaining rectum is small and does not function properly, and the hypermotility of the remnant colon can affect the manifestation of urge fecal incontinence ( 7 , 16 , 17 ).…”

Section: Discussionmentioning

confidence: 99%

“…It can be described as a "disordered bowel function after rectal resection, leading to a detriment in quality of life." (14)(15)(16)(17). The etiology of LARS is poorly understood, and it seems that the anatomical components and physiological functions of normal defecation, which may be damaged during surgery, are not well established (9,18).…”

Section: Introductionmentioning

confidence: 99%

The risk factors of low anterior resection syndrome after colorectal cancer surgery: A retrospective study of 566 patients in a single institution in China

Kang

et al. 2022

Front. Surg.

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PurposeThis study aims to identify the independent risk factors in the low anterior resection syndrome (LARS) after surgery for colorectal cancer (CRC).MethodThis was a retrospective, single-institution study in the Second Affiliation Hospital of Dalian Medical University, China. Patients underwent sphincter-preserving low anterior resection with total or partial mesorectal resection (with or without protective ileostomy) and completed a self-filled questionnaire over the phone to assess postoperative bowel dysfunction from January 2017 to December 2019. The predictors of LAR were evaluated using univariate and multivariate analyses.ResultThe study population was 566 patients, 264 (46.64%), 224 (39.58%), and 78 (13.78%) patients with no, minor, and major LARS, respectively. In the univariate analysis, independent factors such as tumor location and size, anastomotic height, protective ileostomy, post-operation chemoradiotherapy, tumor T stage, lymphatic nodal metastasis classification, surgery duration, and time interval for closure of stoma were significantly associated with LARS points while we found the tumor T stage and lymphatic nodal metastasis classification as the new independent risk factors compared with the last decade studies. In the multivariate analysis, factors such as low and middle tumor location and protective ileostomy, and post operation treatment, nodal metastasis classification were the independent risk factors for major LARS.ConclusionThe new independence risk factors were tumor T stage and lymphatic nodal metastasis status in univariate analysis in our study, with anastomotic height, low and middle tumor location, protective ileostomy, post-operation chemoradiotherapy, nodal metastasis status increasing LARS point in multivariate analysis after surgery for CRC.

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Interactive online informational and peer support application for patients with low anterior resection syndrome: patient survey and protocol for a multicentre randomized controlled trial

Cited by 12 publications

References 22 publications

Mobile applications in gastrointestinal surgery: a systematic review

Mobile applications in gastrointestinal surgery: a systematic review

An online educational and supportive care application for rectal cancer survivors with low anterior resection syndrome: A mixed methods pilot study

The risk factors of low anterior resection syndrome after colorectal cancer surgery: A retrospective study of 566 patients in a single institution in China

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