Personalized Mobile App–Based Program for Preparation and Recovery After Radical Prostatectomy: Initial Evidence for Improved Outcomes From a Prospective Nonrandomized Study
BackgroundeHealth can help replicate the benefits of conventional surgical prehabilitation programs and overcome organizational constraints related to human resources and health care–related costs. ObjectiveWe aimed to assess the impact of an optimized perioperati...
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| Format: | Article |
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JMIR Publications
2024-12-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2024/1/e55429 |
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| author | Alberto Martini Claudia Kesch Alae Touzani Giorgio Calleris Bogdan Buhas Rawad Abou-Zahr Razvan-George Rahota Benjamin Pradère Christophe Tollon Jean-Baptiste Beauval Guillaume Ploussard |
| author_facet | Alberto Martini Claudia Kesch Alae Touzani Giorgio Calleris Bogdan Buhas Rawad Abou-Zahr Razvan-George Rahota Benjamin Pradère Christophe Tollon Jean-Baptiste Beauval Guillaume Ploussard |
| author_sort | Alberto Martini |
| collection | DOAJ |
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BackgroundeHealth can help replicate the benefits of conventional surgical prehabilitation programs and overcome organizational constraints related to human resources and health care–related costs.
ObjectiveWe aimed to assess the impact of an optimized perioperative program using a personalized mobile app designed for preparation and recovery after radical prostatectomy (RP).
MethodsWe report on a series of 122 consecutive robot-assisted RP before and after the implementation of the betty.care app (cohort A: standard of care, n=60; cohort B: optimized program, n=62). The primary end point was continence recovery, defined as “0 or 1 safety pad per day” at 6 weeks after surgery. Secondary end points were length of stay, same-day discharge, complications, readmissions, and number of days alive and out of hospital within 30 days from surgery.
ResultsBoth cohorts were comparable in terms of age, prostate-specific antigen, prostate volume, and disease aggressiveness. Intraoperative parameters (lymph node dissection, operative time, and bilateral nerve-sparing surgery) were comparable in both groups, except for blood loss, which was significantly higher in cohort B (182 vs 125 cc; P=.008). The 6-week continence rate was improved in cohort B in both univariable and multivariable analyses (92% vs 75%; P=.01). There were trends favoring cohort B for all secondary end points with a minimal 30% benefit compared with cohort A. Grade 2 or more complications occurred less frequently in cohort B (13% vs 3.2%; P=.042). Same-day discharge and readmission rates were 35% and 53% (P=.043), and 3.3% and 1.6% (P=.54) in cohorts A and B, respectively. Mean length of stay was reduced by 0.2 days in cohort B (0.58 vs 0.78 days; P=.10). The main limitation was the absence of randomization.
ConclusionsThe implementation of a mobile app that provides a holistic approach to the perioperative period, integrating prehabilitation, rehabilitation, and remote monitoring, could lead to the improvement of important functional outcomes after RP and could replicate an on-site prehabilitation program. Multicenter validation is needed. |
| format | Article |
| id | doaj-art-282f9eedba1d4f41b4120a2bd3fe5cae |
| institution | Kabale University |
| issn | 1438-8871 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj-art-282f9eedba1d4f41b4120a2bd3fe5cae2024-12-13T21:31:14ZengJMIR PublicationsJournal of Medical Internet Research1438-88712024-12-0126e5542910.2196/55429Personalized Mobile App–Based Program for Preparation and Recovery After Radical Prostatectomy: Initial Evidence for Improved Outcomes From a Prospective Nonrandomized StudyAlberto Martinihttps://orcid.org/0000-0003-1272-7154Claudia Keschhttps://orcid.org/0000-0002-2656-2664Alae Touzanihttps://orcid.org/0000-0003-3087-3518Giorgio Callerishttps://orcid.org/0000-0003-3831-1632Bogdan Buhashttps://orcid.org/0000-0002-5981-3802Rawad Abou-Zahrhttps://orcid.org/0000-0003-4241-3738Razvan-George Rahotahttps://orcid.org/0000-0003-2875-2936Benjamin Pradèrehttps://orcid.org/0000-0002-7768-8558Christophe Tollonhttps://orcid.org/0009-0005-8705-5454Jean-Baptiste Beauvalhttps://orcid.org/0000-0002-1532-015XGuillaume Ploussardhttps://orcid.org/0000-0002-6004-2152 BackgroundeHealth can help replicate the benefits of conventional surgical prehabilitation programs and overcome organizational constraints related to human resources and health care–related costs. ObjectiveWe aimed to assess the impact of an optimized perioperative program using a personalized mobile app designed for preparation and recovery after radical prostatectomy (RP). MethodsWe report on a series of 122 consecutive robot-assisted RP before and after the implementation of the betty.care app (cohort A: standard of care, n=60; cohort B: optimized program, n=62). The primary end point was continence recovery, defined as “0 or 1 safety pad per day” at 6 weeks after surgery. Secondary end points were length of stay, same-day discharge, complications, readmissions, and number of days alive and out of hospital within 30 days from surgery. ResultsBoth cohorts were comparable in terms of age, prostate-specific antigen, prostate volume, and disease aggressiveness. Intraoperative parameters (lymph node dissection, operative time, and bilateral nerve-sparing surgery) were comparable in both groups, except for blood loss, which was significantly higher in cohort B (182 vs 125 cc; P=.008). The 6-week continence rate was improved in cohort B in both univariable and multivariable analyses (92% vs 75%; P=.01). There were trends favoring cohort B for all secondary end points with a minimal 30% benefit compared with cohort A. Grade 2 or more complications occurred less frequently in cohort B (13% vs 3.2%; P=.042). Same-day discharge and readmission rates were 35% and 53% (P=.043), and 3.3% and 1.6% (P=.54) in cohorts A and B, respectively. Mean length of stay was reduced by 0.2 days in cohort B (0.58 vs 0.78 days; P=.10). The main limitation was the absence of randomization. ConclusionsThe implementation of a mobile app that provides a holistic approach to the perioperative period, integrating prehabilitation, rehabilitation, and remote monitoring, could lead to the improvement of important functional outcomes after RP and could replicate an on-site prehabilitation program. Multicenter validation is needed.https://www.jmir.org/2024/1/e55429 |
| spellingShingle | Alberto Martini Claudia Kesch Alae Touzani Giorgio Calleris Bogdan Buhas Rawad Abou-Zahr Razvan-George Rahota Benjamin Pradère Christophe Tollon Jean-Baptiste Beauval Guillaume Ploussard Personalized Mobile App–Based Program for Preparation and Recovery After Radical Prostatectomy: Initial Evidence for Improved Outcomes From a Prospective Nonrandomized Study Journal of Medical Internet Research |
| title | Personalized Mobile App–Based Program for Preparation and Recovery After Radical Prostatectomy: Initial Evidence for Improved Outcomes From a Prospective Nonrandomized Study |
| title_full | Personalized Mobile App–Based Program for Preparation and Recovery After Radical Prostatectomy: Initial Evidence for Improved Outcomes From a Prospective Nonrandomized Study |
| title_fullStr | Personalized Mobile App–Based Program for Preparation and Recovery After Radical Prostatectomy: Initial Evidence for Improved Outcomes From a Prospective Nonrandomized Study |
| title_full_unstemmed | Personalized Mobile App–Based Program for Preparation and Recovery After Radical Prostatectomy: Initial Evidence for Improved Outcomes From a Prospective Nonrandomized Study |
| title_short | Personalized Mobile App–Based Program for Preparation and Recovery After Radical Prostatectomy: Initial Evidence for Improved Outcomes From a Prospective Nonrandomized Study |
| title_sort | personalized mobile app based program for preparation and recovery after radical prostatectomy initial evidence for improved outcomes from a prospective nonrandomized study |
| url | https://www.jmir.org/2024/1/e55429 |
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