title: RAPP, a systematic e-assessment of postoperative recovery in patients undergoing day surgery: study protocol for a mixed-methods study design including a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies.
abstract: BACKGROUND
  Day surgery is a well-established practice in many European countries, but only limited information is available regarding postoperative recovery at home though there is a current lack of a standard procedure regarding postoperative follow-up. Furthermore, there is also a need for improvement of modern technology in assessing patient-related outcomes such as mobile applications. This article describes the Recovery Assessment by Phone Points (RAPP) study protocol, a mixed-methods study to evaluate if a systematic e-assessment follow-up in patients undergoing day surgery is cost-effective and improves postoperative recovery, health and quality of life.
  
  
  METHODS
  This study has a mixed-methods study design that includes a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies. 1000 patients >17 years of age who are undergoing day surgery will be randomly assigned to either e-assessed postoperative recovery follow-up daily in 14 days measured via smartphone app including the Swedish web-version of Quality of Recovery (SwQoR) or to standard care (ie, no follow-up). The primary aim is cost-effectiveness. Secondary aims are (A) to explore whether a systematic e-assessment follow-up after day surgery has a positive effect on postoperative recovery, health-related quality of life (QoL) and overall health; (B) to determine whether differences in postoperative recovery have an association with patient characteristic, type of surgery and anaesthesia; (C) to determine whether differences in health literacy have a substantial and distinct effect on postoperative recovery, health and QoL; and (D) to describe day surgery patient and staff experiences with a systematic e-assessment follow-up after day surgery.The primary aim will be measured at 2 weeks postoperatively and secondary outcomes (A-C) at 1 and 2 weeks and (D) at 1 and 4 months.
  
  
  BACKGROUND
  NCT02492191; Pre-results.
authors.affiliation: Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
authors.forename: U
authors.identifier: http://orcid.org/0000-0001-5403-4183
authors.initials: U
authors.lastname: Nilsson
authors.affiliation: Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
authors.forename: M
authors.identifier: http://orcid.org/0000-0001-7574-6745
authors.initials: M
authors.lastname: Jaensson
authors.affiliation: Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Dahlberg
authors.affiliation: Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Odencrants
authors.affiliation: School of Business, Örebro University, Örebro, Sweden.
authors.forename: Å
authors.identifier: http://orcid.org/0000-0002-3713-346X
authors.initials: Å
authors.lastname: Grönlund
authors.affiliation: Faculty of Medicine and Health, Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Hagberg
authors.affiliation: Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
authors.forename: M
authors.identifier: http://orcid.org/0000-0002-5996-2584
authors.initials: M
authors.lastname: Eriksson
mesh_terms: D000556:Ambulatory Surgical Procedures; D001291:Attitude of Health Personnel; D003362:Cost-Benefit Analysis; D057220:Health Literacy; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D063731:Mobile Applications; D011182:Postoperative Care / Q000191:economics* / Q000379:methods*; D036301:Qualitative Research; D011788:Quality of Life; D016037:Single-Blind Method; D000068997:Smartphone
keywords: QUALITATIVE RESEARCH