Improving patient outcomes following total joint arthroplasty: is there an app for that?

Wolfstadt, Jesse; Soong, Christine; Ward, Sarah

doi:10.1136/bmjqs-2019-009571

Cited by 5 publications

(3 citation statements)

References 30 publications

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“…For clinicians, digital technologies can improve communication and information transfer between clinical teams and healthcare sectors 4 , 5 . For healthcare providers and organizations, digital technologies can assist in reducing the burden associated with working at increased capacity, and managing patients with increasing numbers of co-morbidities 6 , 7 . For patients, digital technologies can enhance education provision, improve communication with clinicians, and empower them to play an active role in their own care 4 , 8–10 .…”

Section: Introductionmentioning

confidence: 99%

Digital technology to support lifestyle and health behaviour changes in surgical patients: systematic review

et al. 2020

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Background Digital technologies (such as smartphone applications, activity trackers, and e-learning platforms) have supported patients with long-term conditions to change their lifestyle health behaviours. The aim of this study was to examine the effectiveness of digital technologies in supporting patients undergoing elective surgery to change their health behaviours. Methods A systematic review was conducted of articles reporting a digital intervention supporting behaviour change in adult patients who underwent elective bariatric, oncological or orthopaedic surgery. MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and Scopus were searched from inception to March 2019 for quantitative intervention studies with a specific focus on physical activity, dietary intake, and weight loss in patients before and after surgery (PROSPERO: CRD42019127972). The Joanna Briggs Institute critical appraisal checklist was used to assess study quality. Results Of 3021 citations screened, 17 studies were included comprising 4923 surgical patients; these included experimental (pre–post design, feasibility studies, and RCTs) and observational studies. Three factors were identified as effective for supporting health behaviour change in elective surgical populations: digital technology delivery, implementation, and theoretical underpinning. Six of eight studies that referred to behaviour change theories observed significant improvements in health behaviour relating to reduced weight regain, and improved lifestyle choices for physical activity and diet. Meta-analysis was not possible because of heterogeneous outcome measures. Conclusion Digital technologies may effectively support behavioural change in patients undergoing elective surgery.

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Section: Introductionmentioning

confidence: 99%

Digital technology to support lifestyle and health behaviour changes in surgical patients: systematic review

et al. 2020

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“…They provide education and information in an easily accessible and patient-friendly manner [ 25 , 27 , 28 ] and encourage patients to become active participants in their own care [ 29 , 30 ]. Studies have acknowledged patients’ receptiveness toward using digital technologies to complement the care pathways of other surgical procedures, which has resulted in successful behavior change, improved recovery time, and reduced length of stay in hospital [ 31 - 33 ]. In the bariatric surgery literature, recent studies have reported how telemedicine and digitally supported care have been well received by patients [ 34 ] and have potentially improved postoperative clinic attendance and patient engagement with surgical care [ 25 , 35 , 36 ].…”

Section: Introductionmentioning

confidence: 99%

Designing Digital Health Technology to Support Patients Before and After Bariatric Surgery: Qualitative Study Exploring Patient Desires, Suggestions, and Reflections to Support Lifestyle Behavior Change

Robinson¹,

Husband²,

Slight³

et al. 2022

JMIR Hum Factors

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Background A patient’s capability, motivation, and opportunity to change their lifestyle are determinants of successful outcomes following bariatric surgery. Lifestyle changes before and after surgery, including improved dietary intake and physical activity levels, have been associated with greater postsurgical weight loss and improved long-term health. Integrating patient-centered digital technologies within the bariatric surgical pathway could form part of an innovative strategy to promote and sustain healthier behaviors, and provide holistic patient support, to improve surgical success. Previous research focused on implementing digital technologies and measuring effectiveness in surgical cohorts. However, there is limited work concerning the desires, suggestions, and reflections of patients undergoing bariatric surgery. This qualitative investigation explores patients’ perspectives on technology features that would support behavior changes during the pre- and postoperative periods, to potentially maintain long-term healthy lifestyles following surgery. Objective This study aims to understand how digital technologies can be used to support patient care during the perioperative journey to improve weight loss outcomes and surgical success, focusing on what patients want from digital technologies, how they want to use them, and when they would be of most benefit during their surgical journey. Methods Patients attending bariatric surgery clinics in one hospital in the North of England were invited to participate. Semistructured interviews were conducted with purposively sampled pre- and postoperative patients to discuss lifestyle changes and the use of digital technologies to complement their care. The interviews were audio recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes from the data. Ethical approval was obtained from the National Health Service Health Research Authority. Results A total of 20 patients were interviewed (preoperative phase: 40% (8/20); postoperative phase: 60% (12/20). A total of 4 overarching themes were developed and related to the optimization of technology functionality. These centered on providing tailored content and support; facilitating self-monitoring and goal setting; delivering information in an accessible, trusted, and usable manner; and meeting patient information-seeking and engagement needs during the surgical pathway. Functionalities that delivered personalized feedback and postoperative follow-up were considered beneficial. Individualized goal setting functionality could support a generation of digitally engaged patients with bariatric conditions as working toward achievable targets was deemed an effective strategy for motivating behavior change. The creation of digital package of care checklists between patients and clinicians was a novel finding from this study. Conclusions Perceptions of patients undergoing bariatric surgery validated the integration of digital technologies within the surgical pathway, offering enhanced connectedness and support. Recommendations are made relating to the design, content, and functionality of digital interventions to best address the needs of this cohort. These findings have the potential to influence the co-design and integration of person-centered, perioperative technologies.

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“…(21,22) Studies have acknowledged patients' receptiveness towards using digital technologies to complement the care pathways of other surgical procedures; this has resulted in successful behaviour change, improved recovery time, and reduced length of stay in hospital. (23)(24)(25) In bariatric surgery literature, recent studies have reported how telemedicine and digitally-supported care have been well-received by patients, (26) and have potentially improved post-operative clinic attendance and patient engagement with surgical care. (27,28) Utilising digital technologies within the bariatric surgical pathway, both pre-and post-operatively, could form part of a remote strategy to deliver support and behaviour change advice to patients.…”

Section: Introductionmentioning

confidence: 99%

“We Need to Be Told What to Do and What to Eat”: A Qualitative Study Exploring Perioperative Patient Desires, Suggestions and Reflections on Using Digital Health Technology Before and After Bariatric Surgery. 

Robinson¹,

Husband²,

Slight³

et al. 2020

Preprint

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BackgroundA patient’s capability, motivation, and opportunity to change their lifestyle are significant determinants of successful outcomes following bariatric surgery. Healthier lifestyle changes before and after surgery, including improved dietary intake and physical activity levels, have been shown to contribute to greater post-surgical weight loss and improved long-term health. Integrating patient-centred digital technologies within the bariatric surgical pathway could form part of an innovative strategy to promote and sustain healthier behaviours and provide holistic patient support, to improve surgical success. This study explores the desires, suggestions, and reflections of perioperative patients in the context of integrating digital technologies within the surgical pathway. MethodsPatients attending bariatric surgery clinics within one hospital in the North of England were invited to take part in the study. Semi-structured interviews were conducted with pre- and post-operative patients to discuss lifestyle behaviour change and perspectives of using digital technologies to complement current care. Interviews were audio-recorded and transcribed verbatim. Thematic analysis enabled the development of themes from the data. Ethical approval was obtained from the NHS Health Research Authority.ResultsEighteen patients were interviewed. Four overarching themes were identified relating to patient perspectives of optimised technology functionality to: 1) provide tailored content and support, 2) facilitate self-monitoring and goal-setting, 3) deliver information in an accessible, trusted, and usable manner, and 4) meet patient information-seeking and engagement needs. ConclusionsWe make recommendations to address the unmet needs of this patient cohort. These findings have the potential to influence the design of person-centred, perioperative technologies.

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Improving patient outcomes following total joint arthroplasty: is there an app for that?

Cited by 5 publications

References 30 publications

Digital technology to support lifestyle and health behaviour changes in surgical patients: systematic review

Digital technology to support lifestyle and health behaviour changes in surgical patients: systematic review

Designing Digital Health Technology to Support Patients Before and After Bariatric Surgery: Qualitative Study Exploring Patient Desires, Suggestions, and Reflections to Support Lifestyle Behavior Change

“We Need to Be Told What to Do and What to Eat”: A Qualitative Study Exploring Perioperative Patient Desires, Suggestions and Reflections on Using Digital Health Technology Before and After Bariatric Surgery.

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Improving patient outcomes following total joint arthroplasty: is there an app for that?

Cited by 5 publications

References 30 publications

Digital technology to support lifestyle and health behaviour changes in surgical patients: systematic review

Digital technology to support lifestyle and health behaviour changes in surgical patients: systematic review

Designing Digital Health Technology to Support Patients Before and After Bariatric Surgery: Qualitative Study Exploring Patient Desires, Suggestions, and Reflections to Support Lifestyle Behavior Change

“We Need to Be Told What to Do and What to Eat”: A Qualitative Study Exploring Perioperative Patient Desires, Suggestions and Reflections on Using Digital Health Technology Before and After Bariatric Surgery.&nbsp;

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“We Need to Be Told What to Do and What to Eat”: A Qualitative Study Exploring Perioperative Patient Desires, Suggestions and Reflections on Using Digital Health Technology Before and After Bariatric Surgery.