Automated symptom alerts reduce postoperative symptom severity after XXXX surgery: a randomized controlled clinical trial.

@entity1 @entity1353 @entity5 @entity2 @entity1109 @entity62315 @entity158 @entity1142
PURPOSE: @entity1 receiving @entity5 -related thoracotomy are highly symptomatic in the first weeks after surgery. This study examined whether at-home symptom monitoring plus feedback to clinicians about severe symptoms contributes to more effective postoperative symptom control. @entity1 AND METHODS: We enrolled 100 @entity1 receiving thoracotomy for @entity2 or lung metastasis in a two-arm randomized controlled trial; 79 @entity1 completed the study. After hospital discharge, @entity1 rated symptoms twice weekly for 4 weeks via automated telephone calls. For intervention group @entity1 , an e-mail alert was forwarded to the @entity1 's clinical team for response if any of a @entity1109 ( @entity158 , disturbed sleep, distress, @entity1353 , or @entity1142 ) reached a predetermined severity threshold. No alerts were generated for controls. Group differences in symptom threshold events were examined by generalized estimating equation modeling. RESULTS: The intervention group experienced greater reduction in symptom threshold events than did controls (19% @entity62315 , respectively) and a more rapid decline in symptom threshold events. The difference in average reduction in symptom interference between groups was -0.36 (SE, 0.078; P = .02). Clinicians responded to 84% of e-mail alerts. Both groups reported equally high satisfaction with the automated system and with postoperative symptom control. CONCLUSION: Frequent symptom monitoring with alerts to clinicians when symptoms became moderate or severe reduced symptom severity during the 4 weeks after thoracic surgery. Methods of automated symptom monitoring and triage may improve symptom control after major @entity5 surgery. These results should be confirmed in a larger study.
