Technology-Enabled Remote Monitoring and Self-Management — Vision for Patient Empowerment Following Cardiac and Vascular Surgery: User Testing and Randomized Controlled Trial Protocol

• DOI: 10.2196/resprot.5763
• Publication Date: 2016-08-01T12:30:17Z
• Authors: Michael McGillion; Jennifer Yost; Andrew Turner; Duane Bender; Ted Scott; Sandra Carroll; Paul Ritvo; Elizabeth Peter; Andre Lamy; Gill Furze; Kirsten Krull; Valerie Dunlop; Amber Good; Nazari Dvirnik; Debbie Bedini; Frank Naus; Shirley Pettit; Shaunattonie Henry; Christine Probst; Joseph Mills; Elaine Gossage; Irene Travale; Janine Duquette; Christy Taberner; Sanjeev Bhavnani; James S Khan; David Cowan; Eric Romeril; John Lee; Tracey Colella; Manon Choinière; Jason Busse; Joel Katz; J Charles Victor; Jeffrey Hoch; Wanrudee Isaranuw...; Sharon Kaasalainen; Salima Ladak; Sheila O'Keefe-Mc...; Monica Parry; Daniel I Sessler; Michael Stacey; Bonnie Stevens; Robyn Stremler; Lehana Thabane; Judy Watt-Watson; Richard Whitlock; Joy C MacDermid; Marit Leegaard; Robert McKelvie; Michael Hillmer; Lynn Cooper; Gavin Arthur; Krista Sider; Susan Oliver; Karen Boyajian; Mark Farrow; Chris Lawton; Darryl Gamble; Jake Walsh; Mark Field; Sandra LeFort; Wendy Clyne; Maria Ricupero; Laurie Poole; Karsten Russell-Wood; Michael Weber; Jolene McNeil; Robyn Alpert; Sarah Sharpe; Sue Bhella; David Mohajer; Sem Ponnambalam; Naeem Lakhani; Rabia Khan; Peter Liu; PJ Devereaux
• Keywords: Patient Empowerment

Tens of thousands cardiac and vascular surgeries (CaVS) are performed on seniors in Canada the United Kingdom each year to improve survival, relieve disease symptoms, health-related quality life (HRQL). However, chronic postsurgical pain (CPSP), undetected or delayed detection hemodynamic compromise, complications, related poor functional status major problems for substantial numbers patients during recovery process. To tackle this problem, we aim refine test effectiveness an eHealth-enabled service delivery intervention, TecHnology-Enabled remote monitoring Self-MAnagemenT-VIsion patient EmpoWerment following Cardiac VasculaR surgery (THE SMArTVIEW, CoVeRed), which combines monitoring, education, self-management training optimize outcomes experience undergoing CaVS Kingdom.Our objectives (1) SMArTVIEW via high-fidelity user testing (2) examine a randomized controlled trial (RCT).CaVS clinicians will engage two cycles focus groups usability at site; feedback be elicited about expectations context. The data used eHealth program. Upon transfer surgical ward (ie, post-intensive care unit [ICU]), 256 reassessed postoperatively randomly allocated interactive Web randomization system intervention group usual care. run from day 2 until 8 weeks surgery. Outcome assessments occur postoperative 30; week 8; 3, 6, 9, 12 months. primary outcome is worst postop intensity upon movement previous 24 hours (Brief Pain Inventory-Short Form), averaged across 14 days. Secondary include composite complications compromise-death, myocardial infarction, nonfatal stroke- all-cause mortality site infections, (Medical Outcomes Study Short Form-12), depressive symptoms (Geriatric Depression Scale), health utilization-related costs (health utilization Institute Clinical Evaluative Sciences repository), patient-level cost (Ambulatory Home Care Record). A linear mixed model assess effects outcome, with priori contrast weekly average evaluate endpoint postoperation. We also incremental compared using regression estimate difference expected between groups.Study start-up underway scheduled begin fall 2016.Given our experience, dedicated industry partners, RCT infrastructure, confident can make lasting contribution improving who undergo CaVS.