Patient and caregiver preferences and prioritized outcomes for cardiac surgery: A scoping review and consultation workshop

Objective(s): In light of the absence of patient and caregiver input in Enhanced Re-covery After Surgery Cardiac Surgery guideline development, we conducted a scoping review to identify patient and caregiver preferences and prioritized out-comes related to perioperative care in cardiac surgery and its lifelong impact. Methods: Five electronic databases were searched to retrieve studies investigating patient or caregiver preferences and prioritized outcomes. Information was charted in duplicate and analyzed using descriptive statistics or thematic analysis. A patient and caregiver consultation workshop validated scoping review findings and solicited novel preferences and outcomes.Results: Of the 5292 articles retrieved, 43 met inclusion criteria. Most were from Europe (n = 19, 44%) or North America (n = 15, 35%) and qualitative and quan-titative designs were represented in equal proportions. Fifty-two methods were used to obtain stakeholder preferences and prioritized outcomes, the majority be-ing qualitative in nature (n = 32, 61%). Based on the collective preferences of 3772 patients and caregivers from the review and 17 from the consultation workshop, a total of 108 patient preferences, 32 caregiver preferences, and 19 prioritized out-comes were identified. The most commonly identified theme was information and education. Improved quality of life was the most common patient-prioritized outcome, and all caregiver-prioritized outcomes were derived from the consultation workshop.Conclusions: Patient and caregiver preferences overlap with Enhanced Recovery After Surgery Cardiac Surgery recommendations targeting preoperative risk reduc-tion strategies, prehabilitation, patient engagement technology, and intra-and post-operative strategies to reduce discomfort. To support clinical practice, future research should investigate associations with key surgical outcomes. (J Thorac Car-diovasc Surg 2023

Automated summary

In this study, patient and caregiver preferences and prioritized outcomes related to perioperative care in cardiac surgery were identified through a scoping review and validated through consultation workshops. The most common theme of patient and caregiver preferences was information and education, with improved quality of life being the most common patient-prioritized outcome. The findings have important implications for improving clinical practice in cardiac surgery.