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Assessment of Ileostomy Output Using Telemedicine: A Feasibility Trial.


ABSTRACT:

Background

Ileostomies are a routine part of the care of patients with rectal cancer, but are associated with significant risk for dehydration, readmission, and acute kidney injury. Telemedicine has proven beneficial in decreasing readmission in chronic medical illnesses, but its utility in patients with an ileostomy is not well studied.

Objective

The purpose of this study was to evaluate the feasibility of televideoconferencing in the assessment of ileostomy output.

Design

An institutional review board-approved, prospective clinical trial was conducted at a single institution from November 2014 through December 2015.

Settings

The study was conducted in a single, large academic medical center.

Patients

Patients >18 years of age undergoing surgery with plans for ileostomy were eligible.

Interventions

Televideoconference assessments of ileostomy output and the need for medical intervention were conducted during the postoperative stay and compared with in-person assessment.

Main outcome measures

The primary end point of the trial was the feasibility of using teleconferencing to assess the need for medical intervention, defined as 90% agreement between telemedicine and in-person assessments. Secondary end points included patient/provider satisfaction, and correlative studies examined dehydration events and readmission.

Results

Twenty-seven patients underwent 44 teleconferencing assessments of ileostomy output. Compared with in-person treatment decisions, there was a 95% match (95% CI, 85%-99%). The readmission rate for the study participants was 31%, and 18% experienced dehydration events. Both patients and faculty responded favorably to surveys regarding the use of telemedicine in the perioperative period.

Limitations

The study is limited by its in-hospital use of technology and small sample size.

Conclusions

Televideoconference evaluation is a feasible, reliable means of assessing ileostomy output with high patient and physician acceptance. Our pilot study provides rationale for further study in the postdischarge setting for patients with ileostomies. The incorporation of televideoconference assessment within a teledischarge program may enable early intervention to improve patient outcomes. See Video Abstract at http://links.lww.com/DCR/A455.

SUBMITTER: Bednarski BK 

PROVIDER: S-EPMC8925310 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Publications

Assessment of Ileostomy Output Using Telemedicine: A Feasibility Trial.

Bednarski Brian K BK   Slack Rebecca S RS   Katz Matthew M   You Y Nancy YN   Papadopolous John J   Rodriguez-Bigas Miguel A MA   Skibber John M JM   Matin Surena F SF   Chang George J GJ  

Diseases of the colon and rectum 20180101 1


<h4>Background</h4>Ileostomies are a routine part of the care of patients with rectal cancer, but are associated with significant risk for dehydration, readmission, and acute kidney injury. Telemedicine has proven beneficial in decreasing readmission in chronic medical illnesses, but its utility in patients with an ileostomy is not well studied.<h4>Objective</h4>The purpose of this study was to evaluate the feasibility of televideoconferencing in the assessment of ileostomy output.<h4>Design</h4  ...[more]

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