%0 Journal Article
%@ 1438-8871
%I JMIR Publications
%V 22
%N 6
%P e17417
%T Evaluating Safety and Efficacy of Follow-up for Patients With Abdominal Pain Using Video Consultation (SAVED Study): Randomized Controlled Trial
%A Gunasekeran,Dinesh Visva
%A Liu,Zhenghong
%A Tan,Win Jim
%A Koh,Joshua
%A Cheong,Chiu Peng
%A Tan,Lay Hong
%A Lau,Chee Siang
%A Phuah,Gaik Kheng
%A Manuel,Newsie Donnah A
%A Chia,Che Chong
%A Seng,Gek Siang
%A Tong,Nancy
%A Huin,May Hang
%A Dulce,Suzette Villaluna
%A Yap,Susan
%A Ponampalam,Kishanti
%A Ying,Hao
%A Ong,Marcus Eng Hock
%A Ponampalam,R
%+ Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore, 65 6321 3497, ponampalam@singhealth.com.sg
%K digital health
%K teleconsultation
%K video consultation
%K telereview
%K abdominal pain
%K primary care
%K emergency department
%D 2020
%7 15.6.2020
%9 Original Paper
%J J Med Internet Res
%G English
%X Background: The benefits of telemedicine include cost savings and decentralized care. Video consultation is one form that enables early detection of deteriorating patients and promotion of self-efficacy in patients who are well but anxious. Abdominal pain is a common symptom presented by patients in emergency departments. These patients could benefit from video consultation, as it enables remote follow-up of patients who do not require admission and facilitates early discharge of patients from overcrowded hospitals. Objective: The study aimed to evaluate the safety and efficacy of the use of digital telereview in patients presenting with undifferentiated acute abdominal pain. Methods: The SAVED study was a prospective randomized controlled trial in which follow-up using existing telephone-based telereview (control) was compared with digital telereview (intervention). Patients with undifferentiated acute abdominal pain discharged from the emergency department observation ward were studied based on intention-to-treat. The control arm received routine, provider-scheduled telereview with missed reviews actively coordinated and rescheduled by emergency department staff. The intervention arm received access to a platform for digital telereview (asynchronous and synchronous format) that enabled patient-led appointment rescheduling. Patients were followed-up for 2 weeks for outcomes of service utilization, efficacy (compliance with their disposition plan), and safety (re-presentation for the same condition). Results: A total of 70 patients participated, with patients randomly assigned to each arm (1:1 ratio). Patients were a mean age of 40.0 (SD 13.8; range 22-71) years, predominantly female (47/70, 67%), and predominantly of Chinese ethnicity (39/70, 56%). The telereview service was used by 32 patients in the control arm (32/35, 91%) and 18 patients in the intervention arm (18/35, 51%). Most patients in control (33/35, 94%; 95% CI 79.5%-99.0%) and intervention (34/35, 97%; 95% CI 83.4%-99.9%) arms were compliant with their final disposition. There was a low rate of re-presentation at 72 hours and 2 weeks for both control (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 2/35, 6%, 95% CI 1.0%-20.5%) and intervention (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 3/35, 9%, 95% CI 2.2%-24.2%) arms. There were no significant differences in safety (P>.99) and efficacy (P>.99) between the two groups. Conclusions: The application of digital telereview for the follow-up of patients with abdominal pain may be safe and effective. Future studies are needed to evaluate its cost-effectiveness and usefulness for broader clinical application. Trial Registration: ISRCTN Registry ISRCTN28468556; http://www.isrctn.com/ISRCTN28468556. 
%M 32459637
%R 10.2196/17417
%U https://www.jmir.org/2020/6/e17417
%U https://doi.org/10.2196/17417
%U http://www.ncbi.nlm.nih.gov/pubmed/32459637