%0 Journal Article %@ 1438-8871 %I JMIR Publications %V 26 %N %P e55429 %T Personalized Mobile App–Based Program for Preparation and Recovery After Radical Prostatectomy: Initial Evidence for Improved Outcomes From a Prospective Nonrandomized Study %A Martini,Alberto %A Kesch,Claudia %A Touzani,Alae %A Calleris,Giorgio %A Buhas,Bogdan %A Abou-Zahr,Rawad %A Rahota,Razvan-George %A Pradère,Benjamin %A Tollon,Christophe %A Beauval,Jean-Baptiste %A Ploussard,Guillaume %+ Department of Urology, La Croix du Sud Hospital, 52 Chemin De Ribaute, Quint-Fonsegrives, 31130, France, 33 56340913241, a.martini.md@gmail.com %K prehabilitation %K radical prostatectomy %K robot, outcomes %K continence %K mobile app %K app %K electronic health %K eHealth %K surgical %K human resource %K health care %K single-surgeon %K implementation %K betty.care app %K cohort %K perioperative %K rehabilitation %K mobile health %K mHealth %D 2024 %7 13.12.2024 %9 Original Paper %J J Med Internet Res %G English %X Background: eHealth can help replicate the benefits of conventional surgical prehabilitation programs and overcome organizational constraints related to human resources and health care–related costs. Objective: We aimed to assess the impact of an optimized perioperative program using a personalized mobile app designed for preparation and recovery after radical prostatectomy (RP). Methods: We report on a series of 122 consecutive robot-assisted RP before and after the implementation of the betty.care app (cohort A: standard of care, n=60; cohort B: optimized program, n=62). The primary end point was continence recovery, defined as “0 or 1 safety pad per day” at 6 weeks after surgery. Secondary end points were length of stay, same-day discharge, complications, readmissions, and number of days alive and out of hospital within 30 days from surgery. Results: Both cohorts were comparable in terms of age, prostate-specific antigen, prostate volume, and disease aggressiveness. Intraoperative parameters (lymph node dissection, operative time, and bilateral nerve-sparing surgery) were comparable in both groups, except for blood loss, which was significantly higher in cohort B (182 vs 125 cc; P=.008). The 6-week continence rate was improved in cohort B in both univariable and multivariable analyses (92% vs 75%; P=.01). There were trends favoring cohort B for all secondary end points with a minimal 30% benefit compared with cohort A. Grade 2 or more complications occurred less frequently in cohort B (13% vs 3.2%; P=.042). Same-day discharge and readmission rates were 35% and 53% (P=.043), and 3.3% and 1.6% (P=.54) in cohorts A and B, respectively. Mean length of stay was reduced by 0.2 days in cohort B (0.58 vs 0.78 days; P=.10). The main limitation was the absence of randomization. Conclusions: The implementation of a mobile app that provides a holistic approach to the perioperative period, integrating prehabilitation, rehabilitation, and remote monitoring, could lead to the improvement of important functional outcomes after RP and could replicate an on-site prehabilitation program. Multicenter validation is needed. %R 10.2196/55429 %U https://www.jmir.org/2024/1/e55429 %U https://doi.org/10.2196/55429