Effectiveness, usability, and patient satisfaction of an mHealth application with an integrated ePRO system following lumbar degenerative spinal surgery: A quasi-experimental study.

Abstract

Introduction: There is a lack of comprehensive clinical research to assess potential benefits of mHealth solutions in post discharge follow-up care after spinal surgery.

Purpose: This quasi-experimental study evaluated the effectiveness, usability, and patient satisfaction of an mHealth pathway with an electronic Patient-Reported Outcome (ePRO)-based post-discharge nurse-led intervention for patients undergoing surgery for lumbar spine degenerative disorders, compared to standard care.

Methods: Conducted at a Danish tertiary spine center, this study represents the final stage of a three-phase participatory design. The primary outcome was patient quality of recovery, measured by the Quality of Recovery-15 (QoR-15) questionnaire. Secondary outcomes included patient-perceived usability, assessed with the Danish System Usability Scale (SUS). To capture additional patient insights, an open-ended feedback question was included at the end of the survey.

Results: Data from 150 patients (77 women and 73 men) were analyzed, with 104 in the intervention group and 46 in the comparison group. Both groups showed significant improvement over time, but no significant difference between groups. Of 154 potential SUS respondents, 110 participated. Analysis revealed 48 statements, categorized into five themes: (1) Usability and functionality of the mHealth solution, (2) Feedback on the QoR-15 questionnaire, (3) Safety and support, (4) Missing functions and suggestions for improvements, and (5) Patient satisfaction.

Conclusion: No significant differences in effectiveness between the mHealth pathway and standard care were found for post-surgery recovery in lumbar spine patients. Usability and patient satisfaction were generally high, though suggestions for improvements were noted. The study highlighted the importance of post-discharge support, suggesting that the intervention provided crucial security and support, potentially demonstrating compassion through nurse-led care.