Surgery is a common and effective treatment for cancer. Like any cancer treatments, patients may experience a decrease in physical activity and increased symptoms after surgery. With improvements in surgical care, many patients will return home shortly after surgery. Patients and families are expected to manage their own recovery after surgery at home, and to know when to call their doctors when symptoms get worse or when there are problems with physical activity. Studies have tested ways to learn about a patient’s symptoms at home and have found that this method can improve the quality of care.
However, it’s not clear how best to use this information to improve the care of cancer surgery patients. In addition to symptoms, studies have shown that a patient’s ability to function physically after surgery is related to having complications and being readmitted to the hospital. In most hospitals, the surgeon and the surgical care team is responsible for managing the recovery of surgery patients. Another way is to use electronic monitoring systems to track the patient’s symptoms, and have the patient wear a watch to track physical activity after surgery. The electronic monitoring allows the patients to share their symptoms with the care team in a real-time fashion and allows the care team to see problems early and manage them early.
To test which strategy is best for improving surgical recovery care, this project will complete a randomized trial. The trial will be completed at a large cancer center and two community hospitals. Patients will be randomly assigned to two groups: remote, electronic monitoring, where the patient’s daily steps and symptoms will be monitored by nurses, and nurses will be triggered to call patients who have one or more symptoms and a low number of daily steps; or surgical recovery care provided by the surgeon and surgical team, where patients will call the hospital if they have symptoms and problems with daily activities.
This project will partner with the TapCloud™ to use its electronic system for monitoring. The electronic system can be used on any smartphone, tablet, or computer. This study has the potential to improve the care of cancer surgery patients by being able to identify patients who are at risk for problems after surgery early and be able to act on the problems early.
*All proposed projects, including requested budgets and project periods, are approved subject to a programmatic and budget review by PCORI staff and the negotiation of a formal award contract.