Date of Award

4-2025

Degree Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Advisor

Dr. David Odaba

Second Advisor

Dr. Angela Ongewe

Department

Anaesthesiology (East Africa)

Abstract

Background: Preoperative fasting has been a pillar of the practice of anaesthesiology with the main aim of enhancing patient safety by reducing the risk of aspiration. Current clinical guidelines on preoperative fasting guidelines encourage shorter durations of fasting in keeping with current evidence that shows better patient outcomes while maintaining patient safety. Despite this, adherence to preoperative fasting instructions remains universally poor, with patients enduring long fasting periods. Advances in mobile technology, improving internet access and the widespread availability of smartphones have made mobile health a useful tool in patient care. mHealth applications are being increasingly used in perioperative care. We aimed to evaluate the effect of an mHealth application compared to the standard of care on adherence to preoperative fasting instructions.

Primary objectives: Evaluate the effect of the use of a mHealth application on adherence to preoperative fasting instructions among adult patients undergoing elective surgery at AKUHN

Secondary objectives:

• To evaluate the impact of the use of an mHealth application on adherence to preoperative fasting instructions for solids and liquids, respectively, among adult patients undergoing elective surgery

• To evaluate the usability of the mHealth application using a System Usability Scale (SUS) survey

• To evaluate patient satisfaction with the mHealth application

Study population: Adult patients scheduled for elective surgery at AKUHN

Methods: An open-label parallel randomised controlled study

Results: There was 0% adherence to the fasting instructions for both liquids and solids in both groups. The app group had 0% adherence to fasting instructions for liquids and 3.1% adherence for solids. The control group had 5.1% adherence to fasting instructions for solids and 1.1% adherence for liquids. The median (IQR) fasting duration from solids was11.3(8.7, 14.3) hours in the app group and 11.5(9.8, 13.6)hours in the control group. (p =0.741)The median (IQR) duration of fasting from liquids was 9.9 (7.0,13.4) hours in the app group and 10.6(6.67,12.7) hours in the control group. (p=0.872). The response rate to the survey was 51%. The calculated System Usability Score of the mHealth application was 77.6. Most survey respondents found the application useful, were satisfied with it and would recommend it to other patients.

Conclusions: The proportion of patients who adhere to fasting instructions is universally low, leading to a prolonged duration of fasting. The use of an mHealth app did not have any effect on patient adherence to preoperative fasting instructions.

First Page

1

Last Page

69

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