Let the patient decide - Person-centered postoperative follow-up contacts, initiated via a phone app after day surgery: Secondary analysis of a randomized controlled trial

Background: Patients undergoing day surgery are expected to manage their recovery on their own. Follow-up routines differ, but many patients have expressed a need for more professional support during recovery. The aim of this study was to describe how many follow-up contacts were initiated, and when and why, via a digital solution. Also, we wanted to compare postoperative recovery and characteristics between patients requesting, and patients not requesting, contact. Materials and methods: This was a secondary analysis of a multicenter, two-group, parallel randomized controlled trial. Participants used a digital solution called Recovery Assessment by Phone Points (RAPP) for initiating follow-up contacts after day surgery. The quality of postoperative recovery was measured with the Swedish web-version of Quality of Recovery. Results: Of 494 patients, 84 (17%) initiated contact via RAPP. The most common reasons for initiating contact were related to the surgical wound and pain. Contacts were initiated across the 14-day assessment period, with 62% (62/100) in the first postoperative week. The RAPP contact group had significantly poorer postoperative recovery on days 1-14 compared to those not requesting contact via RAPP (p < 0.001). There was a significantly higher proportion of patients who had undergone general anesthesia in the RAPP contact group (85% [71/84]) compared to the non-RAPP contact group (71% [291/410]), p = 0.003. Conclusion: Letting the patient decide him/herself whether, and when, contact and support is needed during the postoperative period, is possible and does not increase the frequency of contacts. This study investigates a digital solution, RAPP, as one example of a person-centered approach that can be implemented in day surgery follow-up.