ABSTRACT
Purpose/Background: Although telemedicine utilization has increased dramatically during the COVID-19 pandemic, the impact of telemedicine vs. in-person postoperative visits on patient satisfaction has not been studied. Hypothesis/Aim: We hypothesized that telemedicine visits would be non-inferior to in-person visits in terms of postoperative colorectal surgery patient satisfaction. Methods/Interventions: We conducted a randomized non-inferiority trial from September 2020 to February 2021 comparing postoperative telemedicine visit (Arm T) or in-person clinic visit (Arm I) after trans-abdominal colorectal surgery. Key inclusion criteria were patients age ≥ 18 undergoing trans-abdominal colorectal surgery and patients with a computer and/ or mobile phone with both audio and video capabilities. Patients who required planned physical intervention during their first postoperative visit (e.g. drain removal) and patients undergoing trans-anal or anorectal procedures only were excluded. Patients in the experimental group (Arm T) received their first postoperative visit via telemedicine. Patients in the control group (Arm I) received their first postoperative visit in person. All participants were asked to complete a seven-item patient satisfaction survey electronically within 24 hours after each postoperative visit, which was scored out of a total of 35. The primary endpoint was total patient satisfaction score. Secondary endpoints included patient-reported safety, length of visit, willingness of patients to recommend the practice to their peers, 60-day rate of readmission, and 60-day rate of re-operation. Results/Outcome(s): A total of 46 patients were analyzed with 23 each in Arm T and Arm I. The mean age of our study cohort was 50.6 (SD 17.7) years and 52% were female. No significant differences were found between groups in terms of baseline characteristics. With respect to the primary endpoint of total satisfaction score out of 35, mean difference in total scores between patients in Arm T vs. patients in Arm I was -0.6 (97.5% CI -1.7 - ∞), excluding the non-inferiority limit Δ of -2, demonstrating that patient satisfaction scores in Arm T were non-inferior to those in Arm I. There were no significant differences between groups in terms of secondary endpoints. Limitations: Patients who did not have a computer or mobile device with both video and audio capabilities were excluded, which may have introduced selection bias. The conduction of our trial during the COVID-19 pandemic may have influenced patient desire to participate in telemedicine in order to maintain social distancing, which may have resulted in a more expeditious recruitment process compared to non-pandemic times. Conclusions/Discussion: Postoperative telemedicine visits were a safe and time-efficient option that maintained high patient satisfaction compared to in-person postoperative visits during the COVID-19 pandemic. (Table Presented).