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The effectiveness and cost-effectiveness of a web-based intervention to support colorectal cancer patients prepare for and recover from surgery: A randomised controlled trial of the RecoverEsupport intervention.

ABSTRACT: Interventions: The RecoverEsupport digital health intervention: OVERVIEW: RecoverEsupport is a digital health intervention to support patients to prepare for and recover from bowel cancer surgery. The RecoverEsupport intervention is a multicomponent intervention based around a purpose-built website. It is designed to be used pre-surgery, post-surgery and post-discharge, and focuses primarily on patient-managed behaviours to enhance their preparation for and recovery from surgery. Specifically, it supports patients to adhere to the evidence-based patient-led ERAS (Enhanced Recovery After Surgery) recommendations to optimise their recovery. Recommended behaviours include early mobilisation, early oral diet, early fluids, minimisation of opioids and breathing exercises. The intervention is also designed to be accessed by a patient’s support person, so that they can support the patient at each stage of the patient journey. What: In addition to the website, the RecoverEsupport intervention also includes provision of patient prompts (to access the website and to monitor and record their behaviours), clinician prompts (alerting nursing staff when patients are not adhering to the ERAS recommendations) and GP prompts (a list of side effects to ask the patients about post-discharge and management strategies for each side effect - provided once following discharge). Prompts can take the form of SMS, email or fax (GPs only). Procedures: The intervention includes a variety of behaviour change strategies including: Self-monitoring and feedback; Provision of Social support; Instruction on how to perform the target behaviours; Provision of information about health consequences; Provision of information from a credible source; Demonstration of behaviour; Provision of Prompts/cues, as descri Primary outcome(s): Length of Stay: The time elapsed between surgery and discharge, as recorded by Local Health District Medical Records (MR) data[At discharge] Study Design: Purpose: Prevention; Allocation: Randomised controlled trial; Masking: Open (masking not used);Assignment: Parallel;Type of endpoint: Efficacy

DISEASE(S): Public Health-health Promotion/education,Colorectal Cancer,Cancer-bowel-back Passage (rectum) Or Large Bowel (colon)

PROVIDER: 2473125 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:An overarching aim is to create prerequisites for person-centred information and communication. The specific aim is to evaluate if an intervention with a written information and communication support tool and person-centred dialogues can increase patients’ health-related quality of life and preparedness and well-being pre-surgery and during recovery in connection to colorectal cancer (CRC) surgery. Further, the aim is to explain variations in patients’ recovery trajectories during the six months following CRC surgery in order to identify particularly vulnerable sub-groups of patients. The hypothesis is that person-centred information and communication supported by an interactive patient information and education material (PEM) for patients undergoing CRC surgery will lead to improved preparedness for surgery and recovery during recovery 6 months following surgery. Secondary outcomes were decreased length of stay at hospital in relation to surgery, changed behaviour pertaining when and how to seek health care for recovery support, and improved emotional, role and social function, general health status and distress. The study is performed at three surgical departments in Sweden. A combination of quantitative and qualitative methods will be applied. The project started with analysis of existing patient written information and education materials aimed for the patient group at Swedish surgical departments and analyses of conversations between patients and providers in consultations occurring over time before and following surgery. These results provided the basis for the development of the person-centred communication intervention developed in collaboration between people who had undergone CRC surgery, professionals from CRC surgery clinics and researchers with expertise in patient education, person-centred care and CRC surgery. The design is quasi-experimental and longitudinal. Patients are consecutively sampled. Types of data: * patient reported answers in validated questionnaires * information about diagnosis, type of treatments and course of care obtained from patients’ records * recorded consultation conversations with patients between patients and health care providers * narrative interviews with patients 6 months following discharge regarding their recovery after surgery * focus group discussions and individual interviews with professionals regarding how they have perceived using the intervention and how it has functioned.

Dataset Information

The effectiveness and cost-effectiveness of a web-based intervention to support colorectal cancer patients prepare for and recover from surgery: A randomised controlled trial of the RecoverEsupport intervention.

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