Perioperative telemonitoring of older patients with cancer

The majority of cancer patients is aged 65 years and older and require surgery as part of their treatment. Problems after surgery might occur in the vulnerable period after hospital discharge, where monitoring is less intensive than in the hospital. In the past decade, remote home monitoring as part of eHealth solutions has emerged to monitor surgical patients after hospital discharge. We explored the possibilities of perioperative telemonitoring in older patients undergoing cancer surgery, a population often overlooked in eHealth studies. In the Connecare study, older patients with cancer were monitored before and after surgery in the University Medical Center Groningen. Patients considered telemonitoring usable and acceptable, yet a substantial proportion of this frail population might not benefit from innovations in telemonitoring because of technological and patient-related barriers. We found no evident relation between vital signs and symptoms measured in the two weeks after discharge and complications or hospital readmissions. However, measurement of physical activity (steps) appeared to be a valuable method to quantify physical recovery after surgery and was of predictive value for hospital readmissions.Although we could not demonstrate that telemonitoring detects deviations in recovery and complications after hospital discharge in a timely manner, we gained valuable insight into telemonitoring regarding feasibility, study implementation, inclusion of older surgical patients, and analyses of monitored parameters. This thesis contributes to the knowledge required for implementation of accessible and feasible eHealth solutions to ensure the quality and capacity of future healthcare for our aging population