Wouter Leclercq

Personalised perioperative care by e-health after intermediate-grade abdominal surgery: A multicentre, single-blind, randomised, placebo-controlled trial 159 10 INTRODUCTION The length of hospital stay after intermediate-grade abdominal surgery has reduced significantly during past decades because minimally invasive surgical procedures are now typically used. 1 Implementation of rapid-recovery protocols after surgery, and economic pressures to lower the cost of a hospital stay, have also contributed to shortening of time in hospital. 2 These changes of clinical practice have restricted the opportunity for health-care professionals to spend time with their patients before and after surgery, thus affecting negatively the provision of information and postoperative instructions tailored to the individual. 3 High-quality patients’ counselling improves postoperative recovery, 4,5 and as a result of the changes in practice, recovery after minimally invasive surgery is slower than expected. 6,7 Hence, patients will not take full advantage of minimally invasive surgery until optimum guidance and information is provided in the perioperative period. In view of the increase in surgical procedures over past decades, this problem is urgent and should be addressed in an efficient way. 8 We have developed an interactive e-health programme that offers patients personalised care during the perioperative period. Patients receive customised recovery advice and day-to-day feedback tailored to their personal situation by an activity tracker, while an e-consult function enables patients to chat with the health-care provider. 9 Here, we report the findings of a randomised controlled trial of this interactive e-health programme versus standard care in patients undergoing intermediate-grade abdominal general surgical or gynaecological procedures. We postulated that using the e-health programme will lead to quicker patients’ recovery in terms of return to normal activities. Because normal activities vary considerably between participants, we used personalised patient-reported outcome measures to assess the effect of the e-health intervention.