Evaluation of a ubiquitous and interoperable computerised system for remote monitoring of ambulatory post-operative pain: A randomised controlled trial

Abstract

Background:

For economic reasons, i.e., to reduce costs of in-hospital patient accommodations, constant pressure has been applied in recent years to increase the percentage of ambulatory surgeries. Effective control of post-operative pain after ambulatory surgery is challenging to all health professionals. Computerised systems are being implemented more frequently for remote patient monitoring, including during the at-home post-operative period.

Objective:

This study evaluates the feasibility of delivering a computerised system, developed in-house, for remote pain monitoring. It evaluates the user-friendliness of the system and the extent of patient compliance. Finally, a comparative assessment of the system is made with respect to the quality of pain treatment in ambulatory surgery.

Methods:

The participants included 32 adults, aged 18–75, randomly assigned to a control group or to a computerised treatment group. The primary treatment outcome was measured by pain intensity ratings (0–10 NRS) reported several times per day during a five-day monitoring period, using an electronic pain diary combined with a web-based personal health record.

Results and conclusions:

The findings demonstrated the feasibility and suitability of the proposed system for pain management. Its handling was user-friendly, without requiring advanced skill or prior experience. In addition, the results showed that the guidance of health care professionals is essential to patients' satisfaction and positive experience with the system. There were no significant group differences with respect to improvements in the quality of pain treatment; however, this can be explained by the low pain scores registered in both groups, related to the type of surgical interventions recruited and the degrees of pain that are easily treated. To evaluate the benefits from a patient-centred perspective, studies of major ambulatory surgeries or of patients in chronic pain, including oncologic and non-oncologic pain resistant to treatment, are necessary.