ABSTRACT
AIM: To describe a protocol for the pilot phase of a trial designed to test the effect of an mHealth intervention on representation and readmission after adult cardiac surgery. DESIGN: A multisite, parallel group, pilot randomized controlled trial (ethics approval: HREC2020.331-RMH69278). METHODS: Adult patients scheduled to undergo elective cardiac surgery (coronary artery bypass grafting, valve surgery, or a combination of bypass grafting and valve surgery or aortic surgery) will be recruited from three metropolitan tertiary teaching hospitals. Patients allocated to the control group with receive usual care that is comprised of in-patient discharge education and local paper-based written discharge materials. Patients in the intervention group will be provided access to tailored 'GoShare' mHealth bundles preoperatively, in a week of hospital discharge and 30 days after surgery. The mHealth bundles are comprised of patient narrative videos, animations and links to reputable resources. Bundles can be accessed via a smartphone, tablet or computer. Bundles are evidence-based and designed to improve patient self-efficacy and self-management behaviours, and to empower people to have a more active role in their healthcare. Computer-generated permuted block randomization with an allocation ratio of 1:1 will be generated for each site. At the time of consent, and 30, 60 and 90 days after surgery quality of life and level of patient activation will be measured. In addition, rates of representation and readmission to hospital will be tracked and verified via data linkage 1 year after the date of surgery. DISCUSSION: Interventions using mHealth technologies have proven effectiveness for a range of cardiovascular conditions with limited testing in cardiac surgical populations. IMPACT: This study provides an opportunity to improve patient outcome and experience for adults undergoing cardiac surgery by empowering patients as end-users with strategies for self-help. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621000082808.
Subject(s)
Cardiac Surgical Procedures , Telemedicine , Adult , Australia , Humans , Patient Readmission , Pilot Projects , Quality of Life , Randomized Controlled Trials as Topic , Treatment OutcomeABSTRACT
BACKGROUND: Regularly informing families of the condition of their relative can be difficult. Text messaging via mobile telephones may achieve such communication effectively. OBJECTIVE: To test the hypotheses that we could efficiently deliver real-time short message service (SMS) updates to families and that these SMS updates would be accepted and welcomed. DESIGN: Prospective observational study. PARTICIPANTS: Cohort of 91 cardiac surgery patients and 156 family participants. INTERVENTION: At five distinct landmark events, we sent pre-written SMS updates to designated mobile numbers. We used the sendQuick (TalariaX) mobile messaging platform via the internet in our hospital. To alleviate privacy concerns, all patients were referred to as "your loved one". The message confirmed the passing of each landmark and directed the families towards the next one. After the patient's discharge, families were followed up with a telephone call and a five-point Likert scale questionnaire. RESULTS: We successfully sent all five SMS messages for 72 patients to 114 participants (73%). Among 114 participants, all agreed the SMS service was reassuring and that the SMS messages were easy to follow and kept participants informed. Almost all felt the SMS service did not increase anxiety and all disagreed with the SMS service being intrusive. All surveyed participants stated that they would recommend the service to other families. CONCLUSION: We successfully instituted real-time SMS updates. All surveyed participants agreed that these messages were reassuring, informative and easy to follow and that they would recommend the SMS service to other families.
