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JU INSIGHT Feasibility, Acceptability, and Outcomes of a Mobile Health Tool for Radical Cystectomy Recovery
By: Kristin Weiss, MD*, University of Michigan, Ann Arbor; Obafunbi Abimbola, MD*, University of North Carolina at Chapel Hill; Dana Mueller, MS, University of North Carolina at Chapel Hill; Ramsankar Basak, PhD, University of North Carolina at Chapel Hill; Ethan Basch, MD, MS, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, University of North Carolina at Chapel Hill; Taylor Parisse, DO, University of Pittsburgh Medical Center at Harrisburg, Pennsylvania; Judy Hamad, MD, Henry Ford Health, Detroit, Michigan; Matthew Nielsen, MD, MS, University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina; Hung-Jui Tan, MD, MS, University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina; Eric Wallen, MD, University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina; Marc Bjurlin, DO, University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina; Angela B. Smith, MD, MS, University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina * Co-first authors | Posted on: 21 Feb 2024
Weiss K, Abimbola O, Mueller D, et al. Feasibility, acceptability, and outcomes of a mobile health tool for radical cystectomy recovery. J Urol. 2024;211(2):266-275.
Study Need and Importance
Postoperative readmission rates following cystectomy are as high as 43%. Readmissions may be caused by preventable complications such as dehydration, infection, and fever, aligning with the most common postoperative complications after cystectomy. Postoperative education and symptom tracking are essential following cystectomy to reduce readmission rates and information overload.
What We Found
We developed an internet-based mobile health (mHealth) tool to provide education, alerts, and symptom tracking. At 1 week following cystectomy discharge, 88% of patients were using the mHealth tool regularly. Engagement declined over time, with 60% of patients engaging at 45 days and ∼50% at 90 days.
In this study, 36% (n = 12) of patients were seen in the emergency department within 90 days of discharge, most commonly for fever, small-bowel obstruction, dehydration, and pyelonephritis (Figure). The 30-day readmission rate was 18% (n = 6) and the 90-day rate was 30% (n = 10).
Limitations
The study’s small sample size limits our ability to define associations with outcomes. The study’s single-arm design does not allow for a direct comparison with usual care. Finally, the study was conducted at an academic hospital, which may not reflect care at community hospitals.
Interpretation for Patient Care
The mHealth tool is a feasible and acceptable option during the postoperative recovery period after radical cystectomy, as reported by both patients and health care providers. The use of the tool provided patients with valuable educational content and symptom management, and allowed for better engagement with their health care team. The mHealth tool allows for patients to be actively engaged in their recovery. It also offers the opportunity for the health care team to track emerging symptoms in the postoperative period and intervene earlier. Through mHealth, we can continue to improve the quality of care for patients undergoing radical cystectomy and other surgical procedures.
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