Quality of life and patient satisfaction with enhanced recovery protocols

Khan, Shakeeb; Wilson, Timothy R.; Ahmed, Jamil; Owais, Anwar; MacFie, John

doi:10.1111/j.1463-1318.2009.01997.x

Cited by 86 publications

(59 citation statements)

References 53 publications

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“…The majority of the studies evaluating the effectiveness of ERPs have used traditional clinical measures [9], such as length of stay [10], analgesia use [11] and incidence of post-operative morbidity to gauge recovery [4]. However, there has been limited research on patients' experiences of accelerated discharge after shortening of post-operative hospital stay [12].…”

Section: Introductionmentioning

confidence: 99%

‘Am I really ready to go home?’: a qualitative study of patients’ experience of early discharge following an enhanced recovery programme for liver resection surgery

Vandrevala

Senior

Spring

et al. 2016

Support Care Cancer

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2 AbstractPurpose: Fast-track surgery or Enhanced Recovery Programmes (ERP) have been shown to improve patient outcomes with shorter post-operative recovery times, fewer complications and more cost-effective care amongst the reported benefits. Traditionally the effectiveness of ERPs have been assessed by measuring clinical outcomes, with the patient experience often being neglected. The aim of this qualitative study was to ascertain patients' expectations and experiences of fast track surgery and recovery at home within the setting of an Enhanced Recovery Programme (ERP).Method: 20 patients enrolled in the treatment group of the randomised controlled trial 'Enhanced recovery in liver resection surgery' were interviewed pre-operatively and 6 weeks post-surgery. Transcripts were analysed using Thematic Analysis.Results: Patients approached the surgery with a sense of renewed hope. Involvement with the ERP was viewed positively and having milestones to aim for gave patients a sense of purpose. Many felt that real recovery from surgery began at home and so felt positive about having an early discharge. Patients did report some concerns about being discharged early and those who failed to meet milestones or were readmitted to hospital experienced this as failure.Conclusions: This qualitative data demonstrates some of the complexities of patients' expectations and experiences of the ERP. Whilst patients generally experience the ERP positively, they also have concerns about the process. The study highlights areas where additional support may be needed for patients enrolled in ERPs and discharged early.Keywords: qualitative research, enhanced recovery programmes, liver cancer, discharge from hospital The final publication is available at Springer via http://dx

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Section: Introductionmentioning

confidence: 99%

‘Am I really ready to go home?’: a qualitative study of patients’ experience of early discharge following an enhanced recovery programme for liver resection surgery

Vandrevala

Senior

Spring

et al. 2016

Support Care Cancer

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“…Patient-related symptoms [7,8] , quality of life [9] and costeffectiveness [10] have been less commonly reported but are likely to be improved by ERAS when compared with traditional care. Laparoscopic and minimally invasive procedures will further improve outcomes compared with open surgery in ERAS pathways [11] , although remarkably early recovery can also be obtained after open abdominal surgery [12] .…”

Section: Advantages Of the Eras Conceptmentioning

confidence: 99%

Evidence or eminence in abdominal surgery: Recent improvements in perioperative care

Segelman

Nygren

2014

WJG

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Repeated surveys from Europe, the United States, Australia, and New Zealand have shown that adherence to an evidence-based perioperative care protocol, such as Enhanced Recovery After Surgery (ERAS), has been generally low. It is of great importance to support the implementation of the ERAS protocol as it has been shown to improve outcomes after a number of surgical procedures, including major abdominal surgery. However, despite an increasing awareness of the importance of structured perioperative management, the implementation of this complex protocol has been slow. Barriers to implementation involve both patient-and staff-related factors as well as practice-related issues and resources. To support efficient and successful implementation, further educational and structural measures have to be made on a national or regional level to improve the standard of general health care. Besides postoperative morbidity, biological and physiological variables have been quite commonly reported in previous ERAS studies. Little information, however, has been obtained on cost-effectiveness, long-term outcomes, quality of life and patient-related outcomes, and these issues remain important areas of research for future studies.© 2014 Baishideng Publishing Group Inc. All rights reserved. Key words: Enhanced recovery; Surgery; Fast track; Perioperative management; Postoperative outcomeCore tip: There is a strong and evolving evidence base to support Enhanced Recovery After Surgery (ERAS) programs in abdominal surgery. Such pathways are safe and efficient in enhancing recovery and reducing morbidity. However, patient-related outcomes, cost effectiveness and long-term benefits from ERAS protocols need to be studied more carefully in the future. To support efficient and successful implementation, further educational efforts have to be performed on a national or regional level to improve the standard of care in the general population.

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“…Several clinical trials accomplished have proved the feasibility, reliability and validity to assess QOL of patients with colonic cancer pre-or postoperation [11][12][13]. However, there are few literatures on the influence of ERAS protocols and QOL, and no evidence that ERAS adversely affect QOL or patient satisfaction [14].…”

Section: Introductionmentioning

confidence: 98%

Short-term quality of life in patients undergoing colonic surgery using enhanced recovery after surgery program versus conventional perioperative management

et al. 2015

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Quality of life and patient satisfaction with enhanced recovery protocols

Abstract: There is no evidence that ERAS adversely affect HQoL or patient satisfaction. Certain aspects of HQoL such as pain and fatigue may improve with ERAS. Further research is required, especially in the early post-operative period.

Cited by 86 publications

References 53 publications

‘Am I really ready to go home?’: a qualitative study of patients’ experience of early discharge following an enhanced recovery programme for liver resection surgery

‘Am I really ready to go home?’: a qualitative study of patients’ experience of early discharge following an enhanced recovery programme for liver resection surgery

Evidence or eminence in abdominal surgery: Recent improvements in perioperative care

Short-term quality of life in patients undergoing colonic surgery using enhanced recovery after surgery program versus conventional perioperative management

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