Perioperative digital behaviour change interventions for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation: a scoping review

Katarina Åsberg,Marcus Bendtsen

doi:10.1186/s13741-021-00189-1

Katarina Åsberg, Marcus Bendtsen

Open Access

https://doi.org/10.1186/s13741-021-00189-1

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Journal: Perioperative Medicine	Publication Date: Jul 6, 2021
Citations: 6	License type: open-access

Affiliation: Linköping University

Abstract

BackgroundEvidence suggests that unhealthy lifestyle behaviours are modifiable risk factors for postoperative complications. Digital behaviour change interventions (DBCIs), for instance text messaging programs and smartphone apps, have shown promise in achieving lifestyle behaviour change in a wide range of clinical populations, and it may therefore be possible to reduce postoperative complications by supporting behaviour change perioperatively using digital interventions. This scoping review was conducted in order to identify existing research done in the area of perioperative DBCIs for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation.Main textThis scoping review included eleven studies covering a range of surgeries: bariatric, orthopaedic, cancer, transplantation and elective surgery. The studies were both randomised controlled trials and feasibility studies and investigated a diverse set of interventions: one game, three smartphone apps, one web-based program and five text message interventions. Feasibility studies reported user acceptability and satisfaction with the behaviour change support. Engagement data showed participation rates ranged from 40 to 90%, with more participants being actively engaged early in the intervention period. In conclusion, the only full-scale randomised controlled trial (RCT), text messaging ahead of bariatric surgery did not reveal any benefits with respect to adherence to preoperative exercise advice when compared to a control group. Two of the pilot studies, one text message intervention, one game, indicated change in a positive direction with respect to alcohol and tobacco outcomes, but between group comparisons were not done due to small sample sizes. The third pilot-study, a smartphone app, found between group changes for physical activity and alcohol, but not with respect to smoking cessation outcomes.ConclusionThis review found high participant satisfaction, but shows recruitment and timing-delivery issues, as well as low retention to interventions post-surgery. Small sample sizes and the use of a variety of feasibility outcome measures prevent the synthesis of results and makes generalisation difficult. Future research should focus on defining standardised outcome measures, enhancing patient engagement and improving adherence to behaviour change prior to scheduled surgery.

Highlights

Patients undergoing surgery are at risk of postoperative complications, which may result in increased postoperative morbidity and mortality, extended hospital stay and increased societal costs (Wakeam et al, 2015; Tevis et al, 2016)
While the surgical procedure itself may be an unavoidable risk factor, evidence suggests that unhealthy lifestyle behaviours, such as alcohol, diet, physical activity and smoking are modifiable risk factors for postoperative complications (Thomsen et al, 2009; Eliasen et al, 2013; Steffens et al, 2018; Schwegler et al, 2010; Levett et al, 2016; Moller et al, 2003)
As the body of literature on perioperative digital lifestyle behaviour change interventions has not been comprehensively reviewed, and since the topic is heterogenous and not amenable to more precise systematic review, we conducted a scoping review (Peters et al, 2015) in order to identify existing research done in the area of perioperative Digital behaviour change interventions (DBCI) for reducing alcohol consumption, improving diet, increasing physical activity and smoking cessation

Summary

Introduction

Patients undergoing surgery are at risk of postoperative complications, which may result in increased postoperative morbidity and mortality, extended hospital stay and increased societal costs (Wakeam et al, 2015; Tevis et al, 2016). Digital behaviour change interventions (DBCIs), for instance text messaging programs and smartphone apps, have shown promise in achieving lifestyle behaviour change in a wide range of clinical populations, and it may be possible to reduce postoperative complications by supporting behaviour change perioperatively using digital interventions. This scoping review was conducted in order to identify existing research done in the area of perioperative DBCIs for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation

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