Utilization of a novel interactive mobile health platform to evaluate functional outcomes and pain following septoplasty and functional endoscopic sinus surgery

Int Forum Allergy Rhinol. 2019 Apr;9(4):345-351. doi: 10.1002/alr.22273. Epub 2018 Dec 26.

Abstract

Background: Whether for research or quality improvement, assessment of postoperative quality of life outcomes faces a challenge in reliable data collection. Typical coordinator-led studies cite response rates from 35% to 70%. This study evaluates the utility of a digital patient engagement platform to track patient-reported outcome measures (PROMs) following septoplasty and functional endoscopic sinus surgery (FESS).

Methods: A prospective cohort was recruited at a tertiary care center from January 2017 to March 2018. A mobile phone application relayed PROMs, including pain (assessed on a 0 to 10 visual analogue scale [VAS] every other day for 2 weeks, as well as the patient-reported outcome measure information system [PROMIS] pain interference short form 4a at baseline, 2 weeks, and 3 months) and timing of return to work.

Results: Of 288 patients enrolled, 249 (86.5%) provided clinical data, including 208 who underwent septoplasty or FESS. Granular VAS scores, submitted by 195 patients, demonstrated 80% of these patients achieved minimal pain by postoperative day 8. A nonsignificant trend of increased days to pain relief by procedure emerged: septoplasty (mean ± standard deviation [SD], 3.60 ± 2.44), FESS (3.96 ± 3.25), FESS with septoplasty (4.40 ± 3.04), and FESS with drilling (4.86 ± 3.68). Across procedures, PROMIS pain interference increased at 2 weeks (9.17 ± 4.15) and decreased at 3 months (5.32 ± 2.61) compared with baseline (7.09 ± 4.63), with greater improvement noted in the FESS subgroup at 3 months. Patients returned to work at mean 7.1 days regardless of procedure.

Conclusions: With its high response rate, mobile digital patient engagement platforms may effectively track postoperative outcomes with the potential for reduced sample bias.

Keywords: mobile applications; pain measurement; paranasal sinuses; patient participation; patient-reported outcome measures; quality of life; return to work; sinusitis; telemedicine.

MeSH terms

  • Acetaminophen / therapeutic use*
  • Adult
  • Analgesics, Opioid / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Drug Combinations
  • Endoscopy*
  • Female
  • Humans
  • Hydrocodone / therapeutic use*
  • Male
  • Middle Aged
  • Nasal Surgical Procedures*
  • Pain, Postoperative / drug therapy*
  • Patient Reported Outcome Measures*
  • Prospective Studies
  • Return to Work
  • Telemedicine*
  • Visual Analog Scale

Substances

  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal
  • Drug Combinations
  • acetaminophen, hydrocodone drug combination
  • Acetaminophen
  • Hydrocodone