Telemedicine versus face‐to‐face follow up in general surgery: a randomized controlled trial

Abstract

Background: Telemedicine provides healthcare to patients at a distance from their treating clinician. There is a lack of high-quality evidence to support the safety and acceptability of telemedicine for postoperative outpatient follow-up. This randomized controlled trial-conducted before the COVID-19 pandemic-aimed to assess patient satisfaction and safety (as determined by readmission, reoperation and complication rates) by telephone compared to face-to-face follow-up after uncomplicated general surgical procedures. Methods: Patients following laparoscopic appendicectomy or cholecystectomy and laparoscopic or open umbilical or inguinal hernia repairs were randomized to a telephone or face-to-face outpatient clinic. Patient demographics, perioperative details and postoperative outcomes were compared. Patient satisfaction was assessed via a standardized Likert-style scale.Results: One hundred and twenty-three patients were randomized over 12 months. Mean consultation times were significantly shorter for telemedicine than face-to-face clinics (telemedicine 10.52 AE 7.2 min, face-to-face 15.95 AE 9.96 min, P = 0.0021). There was no difference between groups in the attendance rates, nor the incidence or detection of postoperative complications. Of the 58 patients randomized to the telemedicine arm, 40% reported high, and 60% reported very high satisfaction with the method of clinic follow-up. Conclusion: Telemedicine postoperative follow-up is safe and acceptable to patients and could be considered in patients undergoing uncomplicated benign general surgery. adequate provision of post-operative care (including timely diagnosis and management of postoperative complications). This randomized control non-blinded trial-conducted before the COVID-19 pandemic-aimed to assess patient satisfaction and safety (as determined by rates of readmission, return to theatre, missed diagnosis and complications) by telephone compared to face-to-face clinic follow-up after uncomplicated general surgical procedures. MethodsA single-centre randomized controlled trial was performed at a general surgical unit in a metropolitan tertiary hospital from February 2019 to March 2020. Consecutive patients who underwent elective or emergency laparoscopic appendicectomy, laparoscopic cholecystectomy, and laparoscopic or simple open umbilical or inguinal

Digital Health Interventions and Patient Safety in Abdominal Surgery

“…Fourteen studies presented different types of patient satisfaction measures . Patient satisfaction data are available in eTable 2 in Supplement 1.…”

“…Fourteen studies presented different types of patient satisfaction measures. 9 , 10 , 12 , 14 , 15 , 17 , 18 , 19 , 20 , 23 , 26 , 29 , 30 , 31 Patient satisfaction data are available in eTable 2 in Supplement 1 . Overall, the studies reported high levels of patient compliance and satisfaction with telehealth technologies in perioperative management.…”

Examining the Effectiveness of Telephone Clinics: A Review of a Telephone Foot and Ankle Orthopaedic Clinic in a District General Hospital in the United Kingdom

“…There are concerns regarding clinical effectiveness and limitations of virtual physical examinations as well as the potentially widening disparities in access [7]. Fink et al conducted a randomised controlled trial of 123 general surgery patients in an outpatient clinic [8]. They showed that the mean consultation times were significantly shorter for telemedicine than FTF clinics (telemedicine: 10.52 ± 7.2 min, FTF: 15.95 ± 9.96 min, p = 0.0021) while maintaining acceptable patient satisfaction.…”