159 7 Improving Enhanced Recovery After Surgery (ERAS): The Effect of a Patient-Centred Mobile Application Figure 4: Postoperative activity, measured in steps taken per day DISCUSSION The ERAS protocol has improved perioperative care for patients undergoing colorectal surgery. However, challenges persist in optimizing patient engagement and compliance, prompting exploration into innovative mobile healthcare solutions. This study investigated the effectiveness of a patient-centred app, the ERAS App, designed to enhance patient education, participation and activation within the ERAS colorectal pathway. Notably, the ERAS APPtimize trial stands out as the first study to combine an activity tracker with an interactive mobile application classified as a medical device, underscoring its unique approach to supporting patients through the perioperative journey. The ERAS App demonstrated a significant improvement in overall compliance with selected active ERAS elements by 10%, particularly in early solid food intake by 42% and early mobilization by 27%. However, other ERAS elements remained unchanged, as these elements relies partially on healthcare providers. Notably, patient compliance was higher in teaching hospitals than academic hospitals. This can suggest that the ERAS protocol was better implemented in teaching hospitals, however other factors may be of influence such as shorter disease courses, fewer comorbidities, or less complicated surgeries. In line with compliance discrepancies, patients in teaching hospitals had shorter length of hospital stay by three days (p<0.001). It is important to acknowledge that the study involved only
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