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2023 (English)In: Archives of Gynecology and Obstetrics, ISSN 0932-0067, E-ISSN 1432-0711, Vol. 307, no 2, p. 459-471Article in journal (Refereed) Published
Abstract [en]
Purpose The study aimed to determine if planned telephone follow-up, especially when adding structured, oriented coaching, reduces the intensity of postoperative symptoms and decreases analgesics consumption after benign hysterectomy. Methods A randomized, single-blinded, four-armed, controlled multicenter trial of 525 women scheduled for hysterectomy was conducted in 5 hospitals in the southeast health region of Sweden. The women were allocated 1:1:1:1 into four follow-up models: (A) no telephone follow-up (control group); (B) one planned, structured, telephone follow-up the day after discharge; (C) as B but with additional telephone follow-up once weekly for 6 weeks; and (D) as C but with oriented coaching telephone follow-up on all occasions. Postoperative symptoms were assessed using the Swedish Postoperative Symptoms Questionnaire. Analgesic consumption was registered. Unplanned telephone contacts and visits were registered during the 6 weeks of follow-up. Results In total, 487 women completed the study. Neither pain intensity, nor symptom sum score or analgesic consumption differed between the intervention groups. Altogether, 224 (46.0%) women had unplanned telephone contacts and 203 (41.7%) had unplanned visits. Independent of intervention, the women with unplanned telephone contacts had higher pain intensity and symptom sum scores, particularly if an unplanned telephone contact was followed by a visit, or an unplanned visit was preceded by an unplanned telephone contact. Conclusion Telephone follow-up did not seem to affect recovery regarding symptoms or analgesic consumption after benign hysterectomy in an enhanced recovery after surgery (ERAS) setting. Unplanned telephone contacts and visits were associated with more postoperative symptoms, especially pain. Trial registration The study is registered in ClinicalTrial.gov: NCT01526668 retrospectively from January 27; 2012. Date of enrolment of first patient: October 11; 2011.
Place, publisher, year, edition, pages
Springer Heidelberg, 2023
Keywords
Coaching; ERAS; Hysterectomy; Postoperative symptoms; Telephone follow-up
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-188422 (URN)10.1007/s00404-022-06722-x (DOI)000849308000001 ()36050542 (PubMedID)2-s2.0-85137343979 (Scopus ID)
Note
Funding Agencies|Linkoping University; Medical Research Council of Southeast Sweden [FORSS-155141, FORSS-222211, FORSS308441, FORSS-387761]; ALF Grants Region Ostergotland [RO-276871, RO-356651, RO-448391RO 607891, RO-794531]; Futurum the Academy of Health and Care; Region Jonkoping Council [FUTURUM-487481, FUTURUM 579171]
2022-09-142022-09-142023-08-16