title: A personalised eHealth programme reduces the duration until return to work after gynaecological surgery: results of a multicentre randomised trial.
abstract: OBJECTIVE
  To evaluate the effectiveness of an eHealth intervention on recovery and return to work, after gynaecological surgery.
  
  
  METHODS
  Randomised multicentre trial that ran from March 2010 until September 2011.
  
  
  METHODS
  Secondary care in seven general and university hospitals in The Netherlands.
  
  
  METHODS
  A cohort of 215 women (aged 18-65 years) who had a hysterectomy and/or laparoscopic adnexal surgery for a benign indication.
  
  
  METHODS
  The women were randomly assigned to the intervention group (n = 110) or the control group (n = 105). The intervention group received an eHealth programme that provided personalised tailor-made pre- and postoperative instructions on the resumption of daily activities, including work, and tools to improve self-empowerment and to identify recovery problems. The control group was provided with access to a control website.
  
  
  METHODS
  The primary outcome was the duration of sick leave until a full sustainable return to work. Secondary outcome measures were quality of life, general recovery, and pain intensity.
  
  
  RESULTS
  In intention-to-treat analysis the eHealth intervention was effective on time to return to work (hazard ratio 1.43; 95% confidence interval 1.003-2.040; P = 0.048). The median duration of sick leave until a full sustainable return to work was 39 days (interquartile range 20-67 days) in the intervention group and 48 days (interquartile range 21-69 days) in the control group. After 26 weeks pain intensity was lower (visual analogue scale, cumulative odds ratio 1.84; 95% confidence interval 1.04-3.25; P = 0.035) and quality of life was higher (Rand-36 health survey, between-group difference 30, 95% confidence interval 4-57; P = 0.024) in the intervention group, compared with the control group.
  
  
  CONCLUSIONS
  The use of the eHealth intervention by women after gynaecological surgery results in a faster return to work, with a higher quality of life and less pain.
authors: Department of Obstetrics and Gynaecology, & EMGO Institute for Health and Care Research, AMC-UMCG-UWV-VUmc, Amsterdam, the Netherlands; Department of Public and Occupational Health, & EMGO Institute for Health and Care Research, AMC-UMCG-UWV-VUmc, Amsterdam, the Netherlands.
authors: A
authors: A
authors: Vonk Noordegraaf
authors: J R
authors: JR
authors: Anema
authors: W
authors: W
authors: van Mechelen
authors: D L
authors: DL
authors: Knol
authors: W M
authors: WM
authors: van Baal
authors: P J M
authors: PJ
authors: van Kesteren
authors: H A M
authors: HA
authors: Brölmann
authors: J A F
authors: JA
authors: Huirne
mesh_terms: D000290:Adnexa Uteri / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000534:rehabilitation*; D010535:Laparoscopy / Q000009:adverse effects / Q000534:rehabilitation*; D008875:Middle Aged; D009426:Netherlands; D010146:Pain / Q000534:rehabilitation*; D010147:Pain Measurement; D011788:Quality of Life; D062707:Return to Work / Q000706:statistics & numerical data*; D018582:Sick Leave / Q000706:statistics & numerical data; D017216:Telemedicine / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: eHealth intervention; gynaecological surgery; hysterectomy; laparoscopic adnexal surgery; recovery; return to work