Implementation of a perioperative care App in elective thoracic surgery

Olivero, Carlos Alfredo Fraile; Sarceda, José Ramón Jarabo; Martín, Elena Fernández; Santos, Passio; Manzanal, Pedro Daniel Arribas; Martínez, Ana M Gómez; Gastardi, Joaquín Calatayud; Trancho, Florentino Hernando

doi:10.1016/j.cireng.2022.09.022

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…This was a significant number of patients and required an analysis of the causes of this phenomenon, such as age, socioeconomic level, or educational level. Fortunately, our team analyzed, in a prior study, the sociodemographic characteristics of patients in the intervention group, and we demonstrated that neither age nor the educational level of patients limited the implementation and use of the app in our department [20]. However, in recent years, with the rise of new technologies and mobile apps, most devices are compatible with simple apps, and patients are often more familiar with the use of these technological tools.…”

Section: Discussionmentioning

confidence: 96%

The Use of Fissios App© as a Complement to a Face-to-Face Respiratory Physiotherapy Program versus an Attendance-Only Face-to-Face Physiotherapy Program in Patients Scheduled for Thoracic Surgical Procedures Reduces the Risk of Developing Postoperative Pulmonary Complications—A Quasi-Experimental Study

Fraile Olivero,

Jarabo Sarceda,

Fernández Martín

et al. 2023

JCM

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Postoperative pulmonary complications (PPCs) increase the hospital length of stay (LOS) and the cost of healthcare associated with surgical procedures. Strategies to reduce PPCs begin before surgery and continue in the postoperative period. Fissios App© is a smartphone application that contains perioperative medical advice and a structured respiratory physiotherapy program. The objective was to implement the use of this app in a group of patients scheduled for a thoracic surgical procedure and determine its efficacy in reducing PPCs. This was a quasi-experimental study in which all patients attended a face-to-face respiratory physiotherapy program, and the intervention group used Fissios App© as a complement. We prospectively recorded the postoperative evolution of both groups, analyzed the categorical differences and quantitative variables, and created a binary logistic regression model. We recruited 393 patients (131 intervention and 232 control). The intervention group had a lower incidence of PPCs (12.2% versus 24% in the control group, p = 0.006), a shorter LOS (a median of 3 days (IQR = 2–5) versus 4 days (IQR = 3–6, p = 0.001) in the control group), and a reduction in the risk of developing PPCs by 63.5% (OR: 0.365, 95% CI: 0.17–0.78). The use of Fissios App© improved the clinical outcomes after surgery and reduced the probability of developing PPCs.

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Section: Discussionmentioning

confidence: 96%

The Use of Fissios App© as a Complement to a Face-to-Face Respiratory Physiotherapy Program versus an Attendance-Only Face-to-Face Physiotherapy Program in Patients Scheduled for Thoracic Surgical Procedures Reduces the Risk of Developing Postoperative Pulmonary Complications—A Quasi-Experimental Study

Fraile Olivero,

Jarabo Sarceda,

Fernández Martín

et al. 2023

JCM

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“…Indeed, a home rehabilitation program might support the problem of care offer in the preoperative stage but has to be safe and feasible. Several options are currently being studied: for example, a smartphone app involving perioperative recommendations and chest physical exercises [44] or a tele-rehabilitation program with aerobic training [45]. To reduce resource-related barriers, such as those shown in our study, home tele-rehabilitation might help in reducing transportation costs and increasing the accessibility of healthcare services in rural areas or underserved areas.…”

Section: Discussionmentioning

confidence: 99%

Enhanced Recovery after Surgery (ERAS) Implementation and Barriers among Healthcare Providers in France: A Cross-Sectional Study

Clet,

Guy,

Muir

et al. 2024

Healthcare

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The implementation of Enhanced Recovery After Surgery (ERAS) is a challenge for healthcare systems, especially in case of patients undergoing major surgery. Despite a proven significant reduction in postoperative complications and hospital lengths of stay, ERAS protocols are inconsistently used in real-world practice, and barriers have been poorly described in a cohort comprising medical and paramedical professionals. This study aims to assess the proportion of French healthcare providers who practiced ERAS and to identify barriers to its implementation amongst those surveyed. We conducted a prospective cross-sectional study to survey healthcare providers about their practice of ERAS using an online questionnaire. Healthcare providers were contacted through hospital requests, private hospital group requests, professional corporation requests, social networks, and personal contacts. The questionnaire was also designed to explore barriers to ERAS implementation. Identified barriers were allocated by two independent assessors to one of the fourteen domains of the Theoretical Domains Framework (TDF), which is an integrative framework based on behavior change theories that can be used to identify issues relating to evidence on the implementation of best practice in healthcare settings. One hundred and fifty-three French healthcare providers answered the online questionnaire (76% female, median age 35 years (IQR: 29 to 48)). Physiotherapists, nurses, and dieticians were the most represented professions (31.4%, 24.2%, and, 14.4%, respectively). Amongst those surveyed, thirty-one practiced ERAS (20.3%, 95%CI: 13.9 to 26.63). Major barriers to ERAS practice were related to the “Environmental context and resources” domain (57.6%, 95%CI: 49.5–65.4), e.g., lack of professionals, funding, and coordination, and the “Knowledge” domain (52.8%, 95%CI: 44.7–60.8), e.g., ERAS unawareness. ERAS in major surgery is seldom practiced in France due to the unfavorable environment (i.e., logistics issues, and lack of professionals and funding) and a low rate of procedure awareness. Future studies should focus on devising and assessing strategies (e.g., education and training, collaboration, institutional support, the development of healthcare networks, and leveraging telehealth and technology) to overcome these barriers, thereby promoting the wider implementation of ERAS.

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“…Requiere una alta organización de los servicios involucrados y una participación muy activa del paciente y su entorno paraque, en el menor tiempo posible (el que transcurre entre la indicación quirúrgica y la intervención) se alcance un rendimiento óptimo del programa (43). Las nuevas tecnologías están permitiendo llevar estos programas al entorno inmediato del paciente, inclusive a sus dispositivos electrónicos, hasta el punto de que el equipo médico puede disponer en tiempo real de información acerca de la adherencia al programa de prehabilitación por parte del paciente (44).…”

Section: Resección Completa En Cpcnpunclassified

Surgical treatment in lung cancer

Jarabo,

Fernández,

Fraile

et al. 2023

Rev Cancer

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ResumenEl escenario de cáncer de pulmón de célula no pequeña ha cambiado, con nuevos retos como la detección precoz de tumores a través de programas de cribado, abordajes multidisciplinares con nuevos fármacos, una precisa tipificación biomolecular tumoral, el creciente número de pacientes en situación funcional límite que son rescatables para cirugía, y la consecución de resecciones oncológicas completas con abordajes mínimamente invasivos. Los cirujanos torácicos se enfrentan a nódulos pulmonares pequeños sin confirmación citohistológica difíciles de localizar intraoperatoriamente, nuevas peculiaridades técnicas tras tratamientos neoadyuvantes nuevos, pacientes añosos con múltiples comorbilidades y tumores localmente avanzados o metastásicos que se hacen potencialmente resecables tras tratamientos sistémicos. Para ello contamos con nuevas tecnologías como sistemas de asistencia robótica, programas de reconstrucción de imágenes, herramientas para detección y marcaje de nódulos y, especialmente, el entusiasmo de profesionales trabajando para lograr altas tasas de curación y largas supervivencias con máximos niveles de calidad de vida.

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Implementation of a perioperative care App in elective thoracic surgery

Cited by 3 publications

References 28 publications

Enhanced Recovery after Surgery (ERAS) Implementation and Barriers among Healthcare Providers in France: A Cross-Sectional Study

Surgical treatment in lung cancer

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