Impact of smoking status on engagement in remote symptom monitoring after oncologic surgery : Implications for symptom management and readmission rates
(2025) In Cancer 131(3).- Abstract
Background: Remote symptom monitoring (RSM) is an evidence-based strategy shown to mitigate postoperative morbidity; however, platform engagement is required to benefit from RSM. Patients who report current smoking are at high risk for postoperative complications, but it is unknown whether smoking status influences engagement with RSM, symptom severity, or unanticipated acute care visits. Methods: This observational case–control study was conducted in patients undergoing ambulatory oncologic surgery at a large cancer center. The authors examined the effect of current smoking status on adherence to an electronically delivered postoperative recovery-assessment tool. Symptom severity and readmissions by smoking status were also analyzed.... (More)
Background: Remote symptom monitoring (RSM) is an evidence-based strategy shown to mitigate postoperative morbidity; however, platform engagement is required to benefit from RSM. Patients who report current smoking are at high risk for postoperative complications, but it is unknown whether smoking status influences engagement with RSM, symptom severity, or unanticipated acute care visits. Methods: This observational case–control study was conducted in patients undergoing ambulatory oncologic surgery at a large cancer center. The authors examined the effect of current smoking status on adherence to an electronically delivered postoperative recovery-assessment tool. Symptom severity and readmissions by smoking status were also analyzed. Results: In total, 19,481 patients who underwent surgery and were enrolled in RSM were included. The nonresponse rate (28%) in current smokers was significantly greater than the rate observed in never smokers (21%; odds ratio, 1.38; 95% confidence interval, 1.17–1.63; p <.0001). Current smokers reported higher symptom scores for pain, wound swelling, constipation, and anxiety. The observed 30-day readmission rates were 3.6% for current smokers and 2.6% for never smokers, with overlapping confidence intervals. Conclusions: Current smokers report higher symptom burden after surgery yet are less likely to adopt proactive digital postoperative recovery strategies like RSM. Implementation strategies are needed to improve the engagement of current smokers in RSM if benefits are to be realized in this high-risk population.
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- author
- Cracchiolo, Jennifer R. ; Li, Yuelin ; Lui, Michelle L. ; Carlsson, Sigrid V. LU ; Matulewicz, Richard S. and Ostroff, Jamie S.
- organization
- publishing date
- 2025-02
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- digital health care, patient-reported outcomes, remote symptom monitoring, smoking, tobacco
- in
- Cancer
- volume
- 131
- issue
- 3
- article number
- e35708
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- pmid:39840908
- scopus:85215435094
- ISSN
- 0008-543X
- DOI
- 10.1002/cncr.35708
- language
- English
- LU publication?
- yes
- id
- 3a76aff4-2a88-4a47-9e69-587263eba999
- date added to LUP
- 2025-03-24 15:37:38
- date last changed
- 2025-07-14 22:20:02
@article{3a76aff4-2a88-4a47-9e69-587263eba999,
abstract = {{<p>Background: Remote symptom monitoring (RSM) is an evidence-based strategy shown to mitigate postoperative morbidity; however, platform engagement is required to benefit from RSM. Patients who report current smoking are at high risk for postoperative complications, but it is unknown whether smoking status influences engagement with RSM, symptom severity, or unanticipated acute care visits. Methods: This observational case–control study was conducted in patients undergoing ambulatory oncologic surgery at a large cancer center. The authors examined the effect of current smoking status on adherence to an electronically delivered postoperative recovery-assessment tool. Symptom severity and readmissions by smoking status were also analyzed. Results: In total, 19,481 patients who underwent surgery and were enrolled in RSM were included. The nonresponse rate (28%) in current smokers was significantly greater than the rate observed in never smokers (21%; odds ratio, 1.38; 95% confidence interval, 1.17–1.63; p <.0001). Current smokers reported higher symptom scores for pain, wound swelling, constipation, and anxiety. The observed 30-day readmission rates were 3.6% for current smokers and 2.6% for never smokers, with overlapping confidence intervals. Conclusions: Current smokers report higher symptom burden after surgery yet are less likely to adopt proactive digital postoperative recovery strategies like RSM. Implementation strategies are needed to improve the engagement of current smokers in RSM if benefits are to be realized in this high-risk population.</p>}},
author = {{Cracchiolo, Jennifer R. and Li, Yuelin and Lui, Michelle L. and Carlsson, Sigrid V. and Matulewicz, Richard S. and Ostroff, Jamie S.}},
issn = {{0008-543X}},
keywords = {{digital health care; patient-reported outcomes; remote symptom monitoring; smoking; tobacco}},
language = {{eng}},
number = {{3}},
publisher = {{John Wiley & Sons Inc.}},
series = {{Cancer}},
title = {{Impact of smoking status on engagement in remote symptom monitoring after oncologic surgery : Implications for symptom management and readmission rates}},
url = {{http://dx.doi.org/10.1002/cncr.35708}},
doi = {{10.1002/cncr.35708}},
volume = {{131}},
year = {{2025}},
}