Key result
An eHealth program cuts unplanned healthcare utilization ~44% at 6 weeks vs standard care.
Why the study?
Health care utilization after CABG surgery is high and partly unplanned, and eHealth applications have been proposed to reduce care consumption and improve recovery.
Does an eHealth program comprising educational videos and video consultations reduce unplanned health care utilization in patients following nonacute CABG surgery?
RCT (n=280)
Single-blind
1:1
No
Does an eHealth program comprising educational videos and video consultations reduce unplanned health care utilization in patients following nonacute CABG surgery?
Hazard Ratio: 0.56 (95% CI 0.34–0.92)
Absolute Event Rate: 31.6% vs 45.2%
An eHealth strategy with educational videos and video consultations significantly reduced unplanned healthcare utilization and accelerated patient-reported recovery in the first 6 weeks after CABG surgery.
Supports eHealth integration post-CABG to lower unplanned visits; confirms efficacy of video-based recovery tools in cardiac surgery.
BACKGROUND: Health care utilization after coronary artery bypass graft (CABG) surgery is high and is partly of an unplanned nature. eHealth applications have been proposed to reduce care consumption, which involve and assist patients in their recovery. In this way, health care expenses could be reduced and quality of care could be improved. OBJECTIVE: The aim of this study was to evaluate if an eHealth program can reduce unplanned health care utilization and improve mental and physical health in the first 6 weeks after CABG surgery. METHODS: A single-blind randomized controlled trial was performed, in which patients scheduled for nonacute CABG surgery were included from a single center in the Netherlands between February 2020 and October 2021. Participants in the intervention group had, alongside standard care, access to an eHealth program consisting of online education videos and video consultations developed in conjunction with the Dutch Heart Foundation. The control group received standard care. The primary outcome was the volume and costs of a composite of unplanned health care utilization, including emergency department visits, outpatient clinic visits, rehospitalization, patient-initiated telephone consultations, and visits to a general practitioner, measured using the Medical Technology Assessment Medical Consumption Questionnaire. Patient-reported anxiety and recovery were also assessed. Intention-to-treat and "users-only" analyses were used. RESULTS: During the study period, 280 patients were enrolled and randomly allocated at a 1:1 ratio to the intervention or control group. The intention-to-treat analysis consisted of 136 and 135 patients in the intervention and control group, respectively. At 6 weeks, the primary endpoint had occurred in 43 of 136 (31.6%) patients in the intervention group and in 61 of 135 (45.2%) patients in the control group (hazard ratio 0.56, 95% CI 0.34-0.92). Recovery was faster in the intervention group, whereas anxiety was similar between study groups. "Users-only" analysis yielded similar results. CONCLUSIONS: An eHealth strategy comprising educational videos and video consultations can reduce unplanned health care utilization and can aid in faster patient-reported recovery in patients following CABG surgery. TRIAL REGISTRATION: Netherlands Trial Registry NL8510; https://trialsearch.who.int/Trial2.aspx?TrialID=NL8510. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1007/s12471-020-01508-9.
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Steenbergen et al. (2022) conducted an RCT in Coronary artery bypass graft (CABG) surgery (n=280). eHealth program (online education videos and video consultations) vs. Standard care was evaluated on Composite of unplanned health care utilization (emergency department visits, outpatient clinic visits, rehospitalization, patient-initiated telephone consultations, and visits to a general practitioner) (HR 0.56, 95% CI 0.34-0.92). An eHealth program of educational videos and video consultations reduced unplanned health care utilization at 6 weeks compared to standard care (31.6% vs 45.2%; HR 0.56, 95% CI 0.34-0.92).