Impact of Remote Symptom Management on Exercise Adherence After Video-Assisted Thoracic Surgery for Lung Cancer in a Tertiary Hospital in China: Protocol for a Prospective Randomized Controlled Trial
BackgroundRegular pulmonary rehabilitation exercises are crucial for patients with lung cancer after surgery. However, poor adherence to outpatient exercises is difficult to address due to inadequate supervision. The integration of remote symptom management through electronic...
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JMIR Publications
2025-01-01
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| Series: | JMIR Research Protocols |
| Online Access: | https://www.researchprotocols.org/2025/1/e60420 |
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| author | Jianwei Su Cuiling Ye Qian Zhang Yi Liang Jianwei Wu Guixi Liang Yalan Cheng Xiaojuan Yang |
| author_facet | Jianwei Su Cuiling Ye Qian Zhang Yi Liang Jianwei Wu Guixi Liang Yalan Cheng Xiaojuan Yang |
| author_sort | Jianwei Su |
| collection | DOAJ |
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BackgroundRegular pulmonary rehabilitation exercises are crucial for patients with lung cancer after surgery. However, poor adherence to outpatient exercises is difficult to address due to inadequate supervision. The integration of remote symptom management through electronic patient-reported outcomes (ePROs) offers a potential solution to improve adherence by enabling more effective monitoring and intervention.
ObjectiveThis study aims to evaluate the impact of ePRO-based remote symptom management on enhancing adherence to outpatient pulmonary rehabilitation exercises following video-assisted thoracic surgery for lung cancer.
MethodsIn this single-center, prospective, randomized controlled trial, 736 patients undergoing minimally invasive lung resection will be recruited. All patients will use a smartphone app for perioperative management, allowing periodic PRO measurement and recording of exercise participation. Upon discharge, patients will be randomly assigned 1:1 into either an intervention or control group. The intervention group will complete the Perioperative Symptom Assessment for Patients Undergoing Lung Surgery (PSA-Lung) scale on the day of discharge and postdischarge days 3, 7, 14, 21, and 28. Alerts will be triggered at the provider side if any of the 5 core symptoms (pain, cough, shortness of breath, sleep disturbance, and fatigue) scored ≥4, prompting remote symptom management. The control group will complete the PRO measures without triggering alerts. The primary outcome is the rehabilitation exercise adherence rate. Secondary outcomes include postdischarge pulmonary complication rate, 30-day readmission rate, trajectory of symptom severity changes, exercise participation rate, and patient satisfaction.
ResultsThe enrollment of study participants started in December 2023 and is expected to end in March 2025. The final comprehensive analysis of the results is planned for May 2025, after all data have been collected and thoroughly reviewed.
ConclusionsThis study is among the first to investigate the feasibility and effectiveness of ePRO-based remote symptom management in enhancing rehabilitation adherence after video-assisted thoracic surgery for lung cancer. If successful, this approach could significantly influence postoperative care practices and potentially be adopted in similar settings.
Trial RegistrationClinicalTrials.gov NCT05990946; https://clinicaltrials.gov/study/NCT05990946
International Registered Report Identifier (IRRID)DERR1-10.2196/60420 |
| format | Article |
| id | doaj-art-1070f4bf4bc24f119237c9864237359a |
| institution | DOAJ |
| issn | 1929-0748 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Research Protocols |
| spelling | doaj-art-1070f4bf4bc24f119237c9864237359a2025-08-20T02:53:09ZengJMIR PublicationsJMIR Research Protocols1929-07482025-01-0114e6042010.2196/60420Impact of Remote Symptom Management on Exercise Adherence After Video-Assisted Thoracic Surgery for Lung Cancer in a Tertiary Hospital in China: Protocol for a Prospective Randomized Controlled TrialJianwei Suhttps://orcid.org/0009-0000-3869-3808Cuiling Yehttps://orcid.org/0009-0004-5743-9126Qian Zhanghttps://orcid.org/0009-0007-9391-6913Yi Lianghttps://orcid.org/0009-0008-9185-068XJianwei Wuhttps://orcid.org/0009-0009-8147-4550Guixi Lianghttps://orcid.org/0009-0007-9820-9222Yalan Chenghttps://orcid.org/0009-0006-9369-5260Xiaojuan Yanghttps://orcid.org/0009-0003-4957-8698 BackgroundRegular pulmonary rehabilitation exercises are crucial for patients with lung cancer after surgery. However, poor adherence to outpatient exercises is difficult to address due to inadequate supervision. The integration of remote symptom management through electronic patient-reported outcomes (ePROs) offers a potential solution to improve adherence by enabling more effective monitoring and intervention. ObjectiveThis study aims to evaluate the impact of ePRO-based remote symptom management on enhancing adherence to outpatient pulmonary rehabilitation exercises following video-assisted thoracic surgery for lung cancer. MethodsIn this single-center, prospective, randomized controlled trial, 736 patients undergoing minimally invasive lung resection will be recruited. All patients will use a smartphone app for perioperative management, allowing periodic PRO measurement and recording of exercise participation. Upon discharge, patients will be randomly assigned 1:1 into either an intervention or control group. The intervention group will complete the Perioperative Symptom Assessment for Patients Undergoing Lung Surgery (PSA-Lung) scale on the day of discharge and postdischarge days 3, 7, 14, 21, and 28. Alerts will be triggered at the provider side if any of the 5 core symptoms (pain, cough, shortness of breath, sleep disturbance, and fatigue) scored ≥4, prompting remote symptom management. The control group will complete the PRO measures without triggering alerts. The primary outcome is the rehabilitation exercise adherence rate. Secondary outcomes include postdischarge pulmonary complication rate, 30-day readmission rate, trajectory of symptom severity changes, exercise participation rate, and patient satisfaction. ResultsThe enrollment of study participants started in December 2023 and is expected to end in March 2025. The final comprehensive analysis of the results is planned for May 2025, after all data have been collected and thoroughly reviewed. ConclusionsThis study is among the first to investigate the feasibility and effectiveness of ePRO-based remote symptom management in enhancing rehabilitation adherence after video-assisted thoracic surgery for lung cancer. If successful, this approach could significantly influence postoperative care practices and potentially be adopted in similar settings. Trial RegistrationClinicalTrials.gov NCT05990946; https://clinicaltrials.gov/study/NCT05990946 International Registered Report Identifier (IRRID)DERR1-10.2196/60420https://www.researchprotocols.org/2025/1/e60420 |
| spellingShingle | Jianwei Su Cuiling Ye Qian Zhang Yi Liang Jianwei Wu Guixi Liang Yalan Cheng Xiaojuan Yang Impact of Remote Symptom Management on Exercise Adherence After Video-Assisted Thoracic Surgery for Lung Cancer in a Tertiary Hospital in China: Protocol for a Prospective Randomized Controlled Trial JMIR Research Protocols |
| title | Impact of Remote Symptom Management on Exercise Adherence After Video-Assisted Thoracic Surgery for Lung Cancer in a Tertiary Hospital in China: Protocol for a Prospective Randomized Controlled Trial |
| title_full | Impact of Remote Symptom Management on Exercise Adherence After Video-Assisted Thoracic Surgery for Lung Cancer in a Tertiary Hospital in China: Protocol for a Prospective Randomized Controlled Trial |
| title_fullStr | Impact of Remote Symptom Management on Exercise Adherence After Video-Assisted Thoracic Surgery for Lung Cancer in a Tertiary Hospital in China: Protocol for a Prospective Randomized Controlled Trial |
| title_full_unstemmed | Impact of Remote Symptom Management on Exercise Adherence After Video-Assisted Thoracic Surgery for Lung Cancer in a Tertiary Hospital in China: Protocol for a Prospective Randomized Controlled Trial |
| title_short | Impact of Remote Symptom Management on Exercise Adherence After Video-Assisted Thoracic Surgery for Lung Cancer in a Tertiary Hospital in China: Protocol for a Prospective Randomized Controlled Trial |
| title_sort | impact of remote symptom management on exercise adherence after video assisted thoracic surgery for lung cancer in a tertiary hospital in china protocol for a prospective randomized controlled trial |
| url | https://www.researchprotocols.org/2025/1/e60420 |
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