146 Chapter 7 ABSTRACT Introduction: The Enhanced Recovery After Surgery (ERAS) protocol improved perioperative colorectal care. Although the protocol is firmly implemented across hospital settings, there are benefits to gain by actively involving patients in their recovery. The main objective of this study was to investigate whether compliance with selected items in the ERAS protocol could further improve by using a patient-centred mobile application. Method: This multicentre, randomised controlled trial was conducted between October 2019 and September 2022. Patients aged 18 years or older who underwent elective colorectal surgery, and in possession of a smartphone were included. The intervention group used a mobile application combined with an activity tracker to be guided and supported through the ERAS pathway. The control group received standard care and wore an activity tracker to monitor their daily activities. The primary outcome was overall compliance with selected active elements of the ERAS protocol. Results: In total, 140 participants were randomised to either the intervention (n=72) or control group (n=68). The use of the ERAS App demonstrated a significant improvement in overall compliance by 10%, particularly in early solid food intake by 42% and early mobilization by 27%. Postoperative or patient reported outcomes did not differ between groups. Conclusion: Supporting and involving patients is of great importance in optimizing perioperative care and best possible outcome of surgery. The smartphone application ‘ERAS App’ is able to significantly improve adherence to the active elements of the ERAS protocol for colorectal surgery; and thus, may be of importance in optimizing care for patients. Funding: Maag Lever Darm Stichting, European Crohn’s and Colitis Organisation (ECCO) and the ‘Innovation Impulse grant’ from Amsterdam UMC.
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