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Peer-reviewedCC BY-NC-ND 4.0Anz Journal of Surgery

Virtual Care of Acute Diverticulitis: A Phase I/II Randomised Clinical Feasibility Trial

  • Phillip F. Yang1,2
  • Philip Hay1,3
  • Owen R. Hutchings4
  • Rebecca A. Davis4,5
  • Miranda Shaw4
  • Shanmugam S. Somasundaram6
  • Michael J. Solomon1,2,3,7
  • Peter J. Lee1,2,7
  • Kate E. McBride7
  • Daniel Steffens1,3,7
  • Kheng‐Seong Ng1,2,3,6,7
7 affiliations
  1. 1Surgical Outcomes Research Centre (SOuRCe) Royal Prince Alfred Hospital Sydney New South Wales Australia
  2. 2Department of Colorectal Surgery Royal Prince Alfred Hospital Sydney New South Wales Australia
  3. 3Faculty of Medicine and Health, Central Clinical School The University of Sydney Sydney New South Wales Australia
  4. 4Sydney Local Health District Virtual Hospital Sydney New South Wales Australia
  5. 5Department of Emergency Medicine Royal Prince Alfred Hospital Sydney New South Wales Australia
  6. 6Department of Colorectal Surgery Concord Repatriation General Hospital Sydney New South Wales Australia
  7. 7Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital Sydney New South Wales Australia
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Abstract

Background: Acute uncomplicated diverticulitis is commonly managed in hospital in Australia. Virtual care may offer reassurance to clinicians and enable out‐of‐hospital management by providing remote monitoring. This study evaluated the feasibility, safety and acceptability of a virtual care pathway for acute diverticulitis (iCAD).

Methods: This Phase I/II trial comprised a single‐centre pilot of patients managed via the iCAD pathway, followed by a multicentre randomised trial comparing iCAD with conventional inpatient care. The iCAD model involved initial in‐person assessment and intravenous antibiotics, followed by daily medical/nursing videoconferencing, supported by wearable devices and a mobile app for vital signs monitoring. Outcomes included treatment retention (defined as the proportion of patients who remained on the iCAD pathway without crossover to inpatient care), rate of major complications and patient‐reported acceptability.

Results: In Phase I, 10 participants were treated on the iCAD pathway with no withdrawals, crossovers or major complications. In Phase II, 40 patients were randomised and no major complications occurred in either group. Two iCAD patients crossed over to inpatient care for clinical reasons. The treatment retention rate for the virtual care group across both phases of the trial was 93%. Patient‐reported experiences favoured the iCAD group, with more participants rating their care as ‘excellent’ (88% vs. 40%, p = 0.03) and felt their healthcare needs were ‘always’ met (88% vs. 47%, p = 0.02).

Conclusions: Virtual care for acute uncomplicated diverticulitis appears feasible, safe and acceptable, with potential advantages over inpatient care, including superior patient‐reported experience.

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Cite

BibTeXRIS
BibTeX
@article{yang2026virtual,
  title = {{Virtual Care of Acute Diverticulitis: A Phase I/II Randomised Clinical Feasibility Trial}},
  author = {Phillip F. Yang and Philip Hay and Owen R. Hutchings and Rebecca A. Davis and Miranda Shaw and Shanmugam S. Somasundaram and Michael J. Solomon and Peter J. Lee and Kate E. McBride and Daniel Steffens and Kheng‐Seong Ng},
  journal = {Anz Journal of Surgery},
  year = {2026},
  month = jun,
  doi = {10.1111/ans.70826},
  url = {https://doi.org/10.1111/ans.70826},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Virtual Care of Acute Diverticulitis: A Phase I/II Randomised Clinical Feasibility Trial
AU  - Phillip F. Yang
AU  - Philip Hay
AU  - Owen R. Hutchings
AU  - Rebecca A. Davis
AU  - Miranda Shaw
AU  - Shanmugam S. Somasundaram
AU  - Michael J. Solomon
AU  - Peter J. Lee
AU  - Kate E. McBride
AU  - Daniel Steffens
AU  - Kheng‐Seong Ng
PY  - 2026
DA  - 2026/06/30
JO  - Anz Journal of Surgery
DO  - 10.1111/ans.70826
UR  - https://doi.org/10.1111/ans.70826
AB  - Background: Acute uncomplicated diverticulitis is commonly managed in hospital in Australia. Virtual care may offer reassurance to clinicians and enable out‐of‐hospital management by providing remote monitoring. This study evaluated the feasibility, safety and acceptability of a virtual care pathway for acute diverticulitis (iCAD).  Methods: This Phase I/II trial comprised a single‐centre pilot of patients managed via the iCAD pathway, followed by a multicentre randomised trial comparing iCAD with conventional inpatient care. The iCAD model involved initial in‐person assessment and intravenous antibiotics, followed by daily medical/nursing videoconferencing, supported by wearable devices and a mobile app for vital signs monitoring. Outcomes included treatment retention (defined as the proportion of patients who remained on the iCAD pathway without crossover to inpatient care), rate of major complications and patient‐reported acceptability.  Results: In Phase I, 10 participants were treated on the iCAD pathway with no withdrawals, crossovers or major complications. In Phase II, 40 patients were randomised and no major complications occurred in either group. Two iCAD patients crossed over to inpatient care for clinical reasons. The treatment retention rate for the virtual care group across both phases of the trial was 93%. Patient‐reported experiences favoured the iCAD group, with more participants rating their care as ‘excellent’ (88% vs. 40%, p = 0.03) and felt their healthcare needs were ‘always’ met (88% vs. 47%, p = 0.02).  Conclusions: Virtual care for acute uncomplicated diverticulitis appears feasible, safe and acceptable, with potential advantages over inpatient care, including superior patient‐reported experience.
SN  - 1445-1433
SN  - 1445-2197
ER  -