Mobile health technology for remote home monitoring after surgery: a meta-analysis

Author:

Dawes A J12ORCID,Lin A Y34,Varghese C5,Russell M M67,Lin A Y6

Affiliation:

1. Section of Colon and Rectal Surgery, Division of General Surgery, Stanford University School of Medicine, Stanford, California, USA

2. Stanford-Surgery Policy Improvement Research & Education Center, Stanford University School of Medicine, Stanford, California, USA

3. Department of Surgery, Wellington Regional Hospital, Wellington, New Zealand

4. Department of Surgery and Anaesthesia (Wellington), University of Otago, New Zealand

5. Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, New Zealand

6. Section of Colon and Rectal Surgery, Division of General Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA

7. VA Greater Los Angeles Healthcare System, Los Angeles, California, USA

Abstract

Abstract Background Mobile health (mHealth) technology has been proposed as a method of improving post-discharge surveillance. Little is known about how mHealth has been used to track patients after surgery and whether its use is associated with differences in postoperative recovery. Methods Three databases (PubMed, MEDLINE and the Cochrane Central Registry of Controlled Trials) were searched to identify studies published between January 1999 and February 2021. Mobile health was defined as any smartphone or tablet computer capable of electronically capturing health-related patient information and transmitting these data to the clinical team. Comparable outcomes were pooled via meta-analysis with additional studies compiled via narrative review. The quality of each study was assessed based on Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Results Forty-five articles met inclusion criteria. While the majority of devices were designed to capture general health information, others were specifically adapted to the expected outcomes or potential complications of the index procedure. Exposure to mHealth was associated with fewer emergency department visits (odds ratio 0.42, 95 per cent c.i. 0.23 to 0.79) and readmissions (odds ratio 0.47, 95 per cent c.i. 0.29 to 0.77) as well as accelerated improvements in quality of life after surgery. There were limited data on other postoperative outcomes. Conclusion Remote home monitoring via mHealth is feasible, adaptable, and may even promote more effective postoperative care. Given the rapid expansion of mHealth, physicians and policymakers need to understand these technologies better so that they can be integrated into high-quality clinical care.

Publisher

Oxford University Press (OUP)

Subject

Surgery

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