You Are Only as Frail as Your Arteries: Prehabilitation of Elderly Surgical Patients

Durand, Matthew J.; Beckert, Angela K.; Peterson, Carrie Y.; Ludwig, Kirk; Ridolfi, Timothy J.; Lauer, Kathryn K.; Freed, Julie K.

doi:10.1007/s40140-019-00357-6

Cited by 3 publications

(2 citation statements)

References 57 publications

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“… n.a. Colorectal cancer Colorectal cancer surgery Not defined Not defined Durand et al [ 40 ] Review article n.a. n.a.…”

Section: Resultsmentioning

confidence: 99%

“…Six documents did not report their funding and potential conflict of interest and should be considered with caution [ 32 , 35 , 39 , 41 , 62 , 63 ]. Eleven documents, which either did not report a conflict of interest or reported no conflict of interest, received research grants or sponsoring by different national research institutions (non-profit funding), whereas seven documents reported a combination of “none” and “not reported” for conflict of interest and funding [ 21 , 36 , 40 , 46 , 50 , 59 , 60 ]. Four other documents declared a conflict of interest, including a CEO position in a firm providing services used in the study [ 58 ], a consulting position and intellectual property ownership [ 47 ], and financial contributions by medical firms unrelated to the research [ 34 , 37 ].…”

Section: Resultsmentioning

confidence: 99%

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Facilitators and barriers to the implementation of prehabilitation for frail patients into routine health care: a realist review

Sontag,

Kiselev,

Schaller

et al. 2024

BMC Health Serv Res

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Background Despite evidence supporting the effectiveness of prehabilitation as a new preoperative care pathway to optimise perioperative outcomes, its implementation into routine health care is widely pending. Frail patients might particularly benefit from prehabilitation interventions, but facilitating and hindering factors need to be considered in the implementation process. Thus, our aim was to derive a programme theory on what prehabilitation programmes work for frail patients in what circumstances and why. Methods Following Pawson’s realist review approach, preliminary programme theories on facilitators and barriers were established. General and topic-specific databases were searched systematically for facilitators and barriers to the implementation of prehabilitation for frail patients. Articles were included if they dealt with multimodal prehabilitation programmes prior to surgery in a frail population and if they contained information on facilitators and barriers during the implementation process in the full text. Based on these articles, refined programme theories were generated. Results From 2,609 unique titles, 34 were retained for the realist synthesis. Facilitating factors included the individualisation of prehabilitation programmes to meet the patients’ needs and abilities, multimodality, adaption to the local setting and health care system, endorsement by an ambassador and sharing of responsibilities among a multidisciplinary team. Central barriers for frail patients were transportation, lack of social support, and inadequate, overwhelming information provision. Conclusions Implementing prehabilitation as a new care pathway for frail patients requires organisational readiness and adaptability to the local setting. On an individual level, a clear understanding of responsibilities and of the intervention’s goal among patients and providers are necessary. Added attention must be paid to the individualisation to fit the needs and restrictions of frail patients. This makes prehabilitation a resource-intense, but promising intervention for frail surgery patients. Trial registration PROSPERO (CRD42022335282).

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