151 7 Improving Enhanced Recovery After Surgery (ERAS): The Effect of a Patient-Centred Mobile Application Outcome The primary outcome was overall average compliance with selected active ERAS elements (Table 1). To correct for cofounding on digital (il-)literacy, participants completed a questionnaire on use of apps and their mobile proficiency. Secondary outcome measures were postoperative outcomes, such as length of hospital stay (LOS), complications, readmissions, and reinterventions, as well as patient-reported outcomes (PROMs), including quality of life (measured with WHOQOL-BREF), disability (measured with WHODAS 2.0), and satisfaction with the app (measured using a self-developed questionnaire).31,32 Additionally, the activity was assessed from day -7 to surgery, until day 21 post-surgery. Table 1: The presentation and scoring of the selected active ERAS elements Selected active ERAS elements Presentation in application Scoring 1. Preoperative nutritional screening and, as needed, assessment and nutritional support SNAQ scoring tool; information SNAQ ≥ 3 + no dietician visit SNAQ ≥ 3 + dietician visit SNAQ ≤ 2 0 1 1 2. Preoperative carbohydrate treatment * Push reminders to finish carbohydrate treatment; checklist No Yes (1 or 2 bottles) Tube feeding Standard use of nutridrink 0 1 1 1 3. Early mobilization Information; tailored daily goals and reminders; display of progress No mobilization on day 1 Mobilization on day 1 0 1 4. Early intake of oral fluids and solids Information; tailored daily goals and reminders; display of progress No oral intake on day 1 Oral intake on day 1 0 1 5. Early removal of urinary catheters * Information, checklist Not removed on day 1 Removed on day 1 No catheter 0 1 1 6. Use of laxatives Information, checklist No laxatives day 1-3 Laxatives day 1-3 0 1 * The element was not present in all local ERAS protocols of the participating hospitals and therefore was not included in the calculation for overall compliance for these hospitals. Each hospital had a minimum of 5 active elements. Abbreviations: SNAQ Short Nutritional Assessment Questionnaire.
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