Digital health platform reduces hospital stay for surgery patients
A recent study has highlighted the significant benefits of a digital health platform named Pip Care in enhancing the postoperative recovery process for patients undergoing surgery. The research, published in the Journal of Medical Internet Research, demonstrates the platform’s ability to reduce hospital stays through effective engagement with patients and integration of personalised recovery strategies.
Pip Care is designed to support patients throughout their perioperative journey by offering personalised care plans and connecting them with certified health coaches. These coaches collaborate with the patients’ surgical teams to provide tailored guidance and daily recovery tasks. The platform’s objective is to foster patient adherence to recovery plans, thus improving surgical outcomes.
The study was conducted in collaboration between UPMC and the University of Pittsburgh School of Medicine. Researchers invited patients scheduled for elective surgeries at an academic medical centre over a period from November 22, 2022, to March 27, 2023, to participate in the platform from approximately two to four weeks pre-surgery to four weeks post-surgery. Out of 283 patients approached, 172 (60.8%) enrolled in the study. A notable 83.1% of these participants engaged in one or more health coaching sessions, with 97.2% proceeding to surgery, surpassing the industry’s typical 90% to 93% surgical adherence rates. Post-surgery, 70.3% continued to engage with the platform.
The platform maintained an impressive 82% weekly engagement rate, with patients frequently attending multiple health coaching sessions. Feedback gathered from 95 survey submissions revealed high levels of satisfaction, with many patients affirming that the coaching significantly aided their perioperative experience.
A comparative analysis between 128 patients using the Pip Care platform and 268 non-users undergoing the same procedures at the same hospital showed that platform users experienced a 24% reduction in postoperative hospital stay. Specifically, the average stay for Pip Care users was 2.4 days compared to 3.1 days for those not using the service. However, both groups recorded similar rates of return to emergency departments within 30 days post-operation.
Dr. Aman Mahajan, MD, PhD, Peter and Eva Safar Professor and Chair of the Department of Anesthesiology and Perioperative Medicine at the University of Pittsburgh School of Medicine, emphasised the challenge of ensuring adherence to perioperative care plans. He noted, “Ensuring that patients follow through with their prescribed perioperative care plans is crucial for their health and recovery outcomes, but achieving this adherence is often challenging.” Dr. Mahajan hailed the integration of this hybrid digital-telemedicine platform as a significant advancement in clinical care, offering ease of use for both patients and clinicians while enhancing patient outcomes and satisfaction with surgical procedures.
This study contributes to the growing body of evidence supporting digital healthcare’s role in improving the continuity of care in surgery. For instance, a 2022 study from the University of Alabama Birmingham indicated that telehealth interventions had substantially reduced no-show rates among surgical patients. The American College of Surgeons has endorsed telehealth, recognising its potential to enhance access to surgical care, especially for patients in remote or underserved areas, and to empower patients in their health care journeys by facilitating active participation in virtual consultations.
Read MoreBariatric surgery associated with over 50% reduction in cancer risk for individuals with obesity
Bariatric surgery could considerably decrease the risk of cancers related to obesity, such as those of the breast, colon, liver, pancreas, ovaries, and thyroid, in patients with obesity.
“Bariatric surgery, which includes sleeve gastrectomy, gastric bypass, and gastric band procedures, is the principal method for significant weight loss in individuals with obesity,” stated Dr. Vibhu Chittajallu, a gastroenterology fellow at Case Western Reserve University and University Hospitals Cleveland Medical Center, during a Digestive Disease Week media briefing. He highlighted that these procedures offer benefits beyond weight loss, such as enhancements in patients’ mental and physical well-being.
Chittajallu further added, “Emerging evidence suggests that the substantial weight reduction linked with bariatric surgery may also provide a protective shield against the development of cancers associated with obesity. My team and I decided to delve deeper into this trend.”
Chittajallu and his team used TriNetX, a database involving 47 U.S. healthcare institutions and over 107 million patients, to conduct a retrospective study from 2002 to 2022. They singled out adults with a Body Mass Index (BMI) over 35 who underwent bariatric surgery, comparing them with patients with obesity who didn’t have the surgery. The study accounted for risk factors like smoking history, alcohol use, heart disease, hormone therapies, and cancer-screening tests, including 55,789 individuals in each group.
The researchers also used the International Agency for Research on Cancer to identify cancers with “sufficient” evidence of a connection to obesity. This included esophageal adenocarcinoma, multiple myeloma, and cancers of the kidney, colon, rectum, stomach, liver, gallbladder, pancreas, ovary, endometrium, breast, and thyroid.
The results revealed that after ten years, the cumulative occurrence of obesity-related cancer was 4% (n = 2,206) in the bariatric surgery group and 8.9% (n = 4,960) in the nonsurgical control group (HR = 0.482; 95% CI, 0.459-0.507).
Chittajallu pointed out that the bariatric surgery group consistently exhibited lower numbers of new cases for all types of obesity-related cancers, including those of the breast, colon, liver, pancreas, ovaries, and thyroid.
“Although more research is required to fully understand the impact of bariatric surgery on cancer risk,” Chittajallu concluded, “our findings indicate that bariatric surgery is a promising area to investigate.”
Read MoreBariatric surgery may reduce cancer risk in patients with obesity and type 2 diabetes
Research findings derived from a Swedish Obese Subjects (SOS) study, published in Diabetes Care, found that in people with obesity and type 2 diabetes (T2D), bariatric surgery may play a role in cancer prevention. “Durable” remission of T2D is often achieved after weight-loss surgery, further associating it with a reduced cancer risk.
The study examined long-term outcomes after bariatric surgery versus usual care in people with obesity. Researchers examined outcomes of 701 patients with obesity and T2D at baseline. A total of 393 of these patients (mean age, 48.6 years) underwent bariatric surgery while 308 patients (mean age, 50.5 years) received conventional obesity treatment. The investigators analysed cancer events, reported in the Swedish National Cancer Register, over the median follow-up of 21.3 years.
In patients treated with bariatric surgery, the incidence rate for first-time cancer during the follow-up period was 9.1 per 1,000 person-years (95% CI, 7.2–11.5). In contrast, the incidence rate for first-time cancer in patients treated with usual obesity care was 14.1 per 1,000 person-years (95% CI, 11.2–17.7). The incidence rate for first-time cancer diagnosis was significantly lower in the patients treated with bariatric surgery (adjusted hazard ratio [HR], 0.63; 95% CI, 0.44–0.89; P =.008).
Compared with the control group, bariatric surgery was associated with a significantly reduced incidence of cancer in women, (HR, 0.58; 95% CI, 0.38–0.90; P =.016). However, with bariatric surgery in men, there was no similar association (HR, 0.79; 95% CI, 0.46-1.38; P =.0413). Diabetes remission at 10 years follow-up was also associated with a reduction in cancer incidence (HR, 0.40; 95% CI, 0.22–0.74; P =.003).
The ascertainment of diabetes diagnoses was a limitation of the study, which were based on a single time point measurement and/or the use of a diabetes medication. Additionally, the majority of participants in the surgery group had received vertical banded gastroplasty or banding, which is rarely used today. High postoperative mortality following bariatric surgery was reported during the original SOS study.
“In conclusion, with increasing rates of obesity and diabetes worldwide, a greater emphasis on cancer prevention strategies is needed,” the researchers wrote. “Bariatric surgery may greatly reduce the risk of cancer among patients with obesity and diabetes. Durable diabetes remission seems imperative for cancer prevention in patients with obesity and diabetes.”
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