Postoperative Follow-up
Conditions
Keywords
perioperative, surgery, Patient Reported Outcomes Mesuares (PROMs), Complex clinical situation
Brief summary
This research aims to identify, as early as the preoperative phase, groups of patients likely to experience maximum clinical improvement through structured paramedical follow-up based on PROMs. However, the high heterogeneity of the included patients could have masked more pronounced effects in certain subgroups, particularly those at higher risk. Relying on a multicenter approach and a subgroup analysis, our study hypothesizes that certain patient profiles are more likely to significantly benefit from personalized follow-up based on PROMs. The objective is to validate the hypothesis that support through PROMs for patients in complex situations could allow for a more pronounced clinical effect. This follow-up will enable better targeting of interventions from the preoperative phase, optimize the use of healthcare resources, and improve quality, safety, and efficiency of perioperative pathways.
Detailed description
The study is an open-label, multicenter, randomized controlled trial comparing two groups: * A control group receiving the usual conventional follow-up, notably by the surgeon and the attending physician. * An experimental group receiving, in addition to the usual conventional follow-up, follow-up by dedicated nurses focusing on the patient's perspective regarding their health status (OPTIMISTE follow-up).
Interventions
Description - Patient-Reported Outcomes-based perioperative follow-up (QoR-15 focus) The Patient-Reported Outcomes-based perioperative follow-up is a patient-centered approach that evaluates postoperative recovery using standardized questionnaires completed directly by the patient. This method highlights the patient's own perception of recovery-covering physical comfort, emotional state, independence, and pain control-rather than relying solely on clinical or physiological parameters. The Quality of Recovery-15 (QoR-15) questionnaire is a validated, short-form tool designed to measure the quality of postoperative recovery from the patient's perspective. It consists of 15 items covering five key dimensions: Physical comfort (pain, nausea, general well-being), Emotional state (anxiety, depression, feeling of support), Psychological support, Physical independence (ability to move or perform daily activities), Pain and symptom management.
Sponsors
University Hospital, Strasbourg, France
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Male or female * Adult patient, with no upper age limit * Undergoing scheduled or unscheduled surgery in a center participating in the research * Presenting a care situation identified as complex, defined by a COMID score \> 9 * Subject affiliated to a social health insurance scheme * Subject able to understand the objectives and risks related to the research and to give informed consent, dated and signed
Exclusion criteria
* Inability to administer the mQoR-15f questionnaire (cognitive disorders, language barrier) * Inability to provide the subject with informed information (subject in an emergency situation, difficulties in understanding, etc.) * Patient who has already received previous follow-up by the OPTIMISTE team * Patient enrolled in a therapeutic trial that may affect post-operative recovery quality * Subject under legal protection, guardianship or curatorship * Pregnant or breastfeeding woman
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The main objective is to evaluate the effectiveness of a perioperative follow-up integrating the patient's perspective based on their perceived health status. | Between the baseline consultation and day 35 | Evolution of a modified version of the French Quality-Of-Recovery 15 score (QoR-15f) between the baseline consultation and postoperative day 35 (depending on the groups: with or without the OPTISMISTE program). The evoluation is scored from 0 to 150 (A higher score indicates better quality of recovery.) |
Outcome results
None listed