Who profits from a perioperative guidance by an app? An interventional analysis on the usage of a health care application (app) in cataract surgery patients (Preprint)

Abstract

Cataract surgeries are among the most conducted surgeries worldwide. A thorough patient education is essential to inform about the perioperative process and postoperative target results concerning the intraocular lens and objectives for visual outcomes. However, addressing all relevant aspects and questions is time-consuming. Applications on mobile phones (mHealth) can facilitate this process for both, patients and physicians.

To evaluate the user-friendliness of an application on mobile phones for patients undergoing cataract surgery and characteristics of patients who profit most of the application usage.

From August 2020 till July 2021 (n= 297) patients that underwent cataract surgery at an ophthalmological practice center were enrolled in this trial. Patients willing to participate were randomized into three different groups. Half of the patients were offered to participate in the interventional group 1 with usage of the application ‘Patient journey app’. However, if they decided not to use the app they were included in group 2 of app deniers. The other half was included in a control group receiving no information about the app and informed conventionally (group 3). The app provided general information on the ophthalmological center, surgeons of the clinic, cataract and treatment options. Different questionnaires were used in all 3 groups to evaluate satisfaction with the perioperative process and the clinic. Group 1 also evaluated the app. Demographical characteristics such as age, gender and educational degree were assessed.

77 Patients were enrolled in group 1 which was using the app (median age 69). 61 patients denied the usage (group 2), whose age was significantly higher (median age 79). 159 patients were included in group 3 (median age 74). The educational background in all groups was diverse. There was no difference in satisfaction with the perioperative process and clinic between the three groups. Almost all patients that used the app appreciated the digital offers provided for organization and information on the surgery. Age did not play a major role in the appreciation of the app. Females tend to appreciate the information provided more than men. Patients that do not have a higher degree of a university took most profit of the informational content of the application and were most satisfied with the offer. However, men and academics are in general more technophile and handle the app more easily. Nevertheless, the other groups take more profit of the app accompanying the cataract surgery journey.

Mobile applications in health care have capacity to improve satisfaction, knowledge and work flows. However, they still face challenges regarding clinical effectiveness, acceptance among patients, integration in health care settings and safety and privacy. Further analyses are needed to address these shortcomings.