INTRODUCTION: Approximately 80% of breast cancer patients have surgery. Many commence radiation therapy soon afterwards and need to be physically and mentally prepared for and recovered from their surgery in preparation for the next phase of treatment. Up to 30% of the recovery from surgery is under the direct control of the patient. Best-practice ERAS (Enhanced Recovery After Surgery) guidelines include the following patient-managed recommendations: early mobilisation, eating and drinking; opioid minimisation; physiotherapy/exercises. Patients need support to adhere to these recommendations and a Digital Health Intervention (DHI) may provide an effective, cost-effective, and scalable solution.
AIMS: This RCT aims to evaluate the effectiveness and cost-effectiveness of the ‘RecoverEsupport’ DHI in increasing adherence to the patient-managed ERAS recommendations among breast cancer surgical patients (mastectomy and reconstruction). The study protocol is presented here.
METHODS: 140 eligible patients (low-risk, 18-80 years, internet access) will be recruited from the surgical lists at the Calvary Mater Newcastle (NSW, Australia). Patients will be randomised (1:1) to receive usual care (control) or ‘RecoverEsupport’ (intervention). The DHI incorporates the following evidence-based behaviour change strategies: information provision, skills training, self-monitoring and feedback, and prompts and cues. The primary trial outcome is Length of Hospital Stay. Secondary outcomes include: Quality of Life (EORTC QLQ-C30) 1-month post-discharge, ED admissions, Quality of Recovery, and health service utilisation. Adherence to patient-managed ERAS recommendations will be assessed via self-report during the hospital admission.
RESULTS & CONCLUSIONS: If effective, the intervention could be rapidly rolled-out at scale and adapted for other surgical patient groups.