Impact of smoking status on engagement in remote symptom monitoring after oncologic surgery: Implications for symptom management and readmission rates Journal Article

   

Authors:	Cracchiolo, J. R.; Li, Y.; Lui, M. L.; Carlsson, S. V.; Matulewicz, R. S.; Ostroff, J. S.
Article Title:	Impact of smoking status on engagement in remote symptom monitoring after oncologic surgery: Implications for symptom management and readmission rates
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. 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. © 2025 American Cancer Society.
Keywords:	adult; controlled study; middle aged; cancer surgery; major clinical study; case control study; constipation; fatigue; hysterectomy; laparoscopic surgery; quality of life; nausea; smoking; nephrectomy; dyspnea; fever; cancer center; hospitalization; prostatectomy; emergency care; anxiety; hospital readmission; patient-reported outcomes; tobacco; observational study; postoperative pain; swelling; patient-reported outcome; symptom burden; human; male; female; article; likert scale; people by smoking status; current smoker; digital health; remote symptom monitoring; telemonitoring; digital health care
Journal Title:	Cancer
Volume:	131
Issue:	3
ISSN:	0008-543X
Publisher:	Wiley Blackwell
Date Published:	2025-02-01
Start Page:	e35708
Language:	English
DOI:	10.1002/cncr.35708
PROVIDER:	scopus
PUBMED:	39840908
PMCID:	PMC11893011
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85215435094&doi=10.1002%2fcncr.35708&partnerID=40&md5=4cb03fc75888446b8e7a9e11ff88f619
Notes:	The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Jennifer R. Cracchiolo -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/222138