☆ 4.8 Review

Cost-effectiveness of prehabilitation prior to elective surgery: a systematic review of economic evaluations

BMC MEDICINE (2023)

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Article Surgery

Actionable Factors Fostering Health Value Generation and Scalability of Prehabilitation A Prospective Cohort Study

Raquel Risco et al.

Summary: Prehabilitation has potential for improving surgical outcomes, but its scalability is limited by an efficacy-effectiveness gap. This study found that completion of the prehabilitation program can reduce hospital and intensive care unit stays, and also save costs.

ANNALS OF SURGERY (2023)

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Article Rehabilitation

Patient and healthcare provider experience and perceptions of a preoperative rehabilitation class for lumbar discectomy: A qualitative study

Hanan Alsaif et al.

Summary: The study aimed to understand the experiences, perspectives, and preferences of patients and healthcare providers regarding preoperative rehabilitation for lumbar disc disease. The results showed that the preoperative class was valuable for both patients and healthcare providers. However, barriers to patient attendance included travel distance, transportation links, parking difficulty, lack of knowledge about the class aims, and previous negative experiences. Addressing these challenges could improve attendance rates.

MUSCULOSKELETAL SCIENCE AND PRACTICE (2023)

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Article Surgery

Effects of Community-based Exercise Prehabilitation for Patients Scheduled for Colorectal Surgery With High Risk for Postoperative Complications: Results of a Randomized Clinical Trial

Annefleur E. M. Berkel et al.

Summary: This study assessed the effects of a 3-week community-based exercise program on 30-day postoperative complications in high-risk patients scheduled for elective colorectal resection. The study found that exercise prehabilitation reduced the rate of postoperative complications.

ANNALS OF SURGERY (2022)

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Review Anesthesiology

Prehabilitation in adult patients undergoing surgery: an umbrella review of systematic reviews

Daniel I. McIsaac et al.

Summary: This umbrella review investigated the impact of prehabilitation on postoperative outcomes and found that it may improve functional recovery and reduce the risk of complications, non-home discharge, and length of stay. However, the certainty of the existing evidence is low, and more high-quality research is needed to support these findings.

BRITISH JOURNAL OF ANAESTHESIA (2022)

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Review Anesthesiology

Prehabilitation, enhanced recovery after surgery, or both? A narrative review

Chelsia Gillis et al.

Summary: This narrative review provides a biological rationale and evidence to explain how the preoperative condition of patients affects postoperative morbidity. Preoperative factors that impede the patient's ability to tolerate the physiological stress of surgery, impair the stress response, and increase the catabolic response to stress are risk factors for poor surgical outcomes. Prehabilitation interventions can be used before surgery to enhance physiological reserve and functional capacity, supporting surgical recovery.

BRITISH JOURNAL OF ANAESTHESIA (2022)

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Article Surgery

Prehabilitation in patients undergoing colorectal surgery fails to confer reduction in overall morbidity: results of a single-center, blinded, randomized controlled trial

Severin Gloor et al.

Summary: This study aimed to assess the impact of prehabilitation on postoperative complications in patients undergoing colorectal surgery within an enhanced recovery after surgery (ERAS) protocol. The results showed that routine physiotherapeutic prehabilitation did not provide additional benefits for patients in terms of reducing postoperative complications.

LANGENBECKS ARCHIVES OF SURGERY (2022)

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Article Nutrition & Dietetics

Structured presurgery prehabilitation for aged patients undergoing elective surgery significantly improves surgical outcomes and reduces cost: A nonrandomized sequential comparative prospective cohort study

Frederick H. Koh et al.

Summary: The study examined the effectiveness of a structured prehabilitative program for aged colorectal cancer patients in improving short-term surgical outcomes. Implementing the program resulted in a reduction in hospitalization duration, improved quality of life after surgery, and cost savings.

NUTRITION IN CLINICAL PRACTICE (2022)

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Article Economics

Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) Statement: Updated Reporting Guidance for Health Economic Evaluations

Don Husereau et al.

Summary: The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement was created to ensure health economic evaluations are identifiable, interpretable, and useful for decision making. The new CHEERS 2022 statement replaces previous guidance and reflects the need for guidance that can be applied to all types of health economic evaluation and includes stakeholder involvement.

VALUE IN HEALTH (2022)

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Review Health Care Sciences & Services

Finding value with prehabilitation in older persons receiving surgery

Priscilla Ng et al.

Summary: Prehabilitation is an effective approach to optimize functional outcomes for older and frail patients undergoing surgery. Multimodal prehabilitation programs can improve treatment efficacy, and targeting high-risk patients can maximize the utilization of prehabilitation resources. Future research should focus on addressing the specific needs and preferences of older patients and comprehensively evaluating the value of prehabilitation.

CURRENT OPINION IN SUPPORTIVE AND PALLIATIVE CARE (2022)

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Article Oncology

PRehabllitatiOn with pReoperatIve exercise and educaTion for patients undergoing major abdominal cancer surgerY: protocol for a multicentre randomised controlled TRIAL (PRIORITY TRIAL)

Daniel Steffens et al.

Summary: This study aims to establish the effectiveness of a progressive, individualized, preoperative exercise and education program compared to usual care in reducing postoperative complications for patients with advanced primary or recurrent gastrointestinal cancers. The secondary aims include investigating the effect on length of hospital stay, quality of life, and costs.

BMC CANCER (2022)

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Article Anesthesiology

Home-based prehabilitation with exercise to improve postoperative recovery for older adults with frailty having cancer surgery: the PREHAB randomised clinical trial

Daniel I. McIsaac et al.

Summary: Home-based prehabilitation does not significantly improve postoperative recovery or other outcomes in older adults with frailty undergoing cancer surgery. Program adherence may be a key factor in the efficacy of prehabilitation.

BRITISH JOURNAL OF ANAESTHESIA (2022)

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Article Oncology

Neoadjuvant Prehabilitation Therapy for Locally Advanced Non-Small-Cell Lung Cancer: Optimizing Outcomes Throughout the Trajectory Care

Severin Schmid et al.

Summary: This proof-of-concept study analyzed non-small-cell lung cancer patients who underwent simultaneous prehabilitation and neoadjuvant therapy. The results showed that neoadjuvant prehabilitation therapy is feasible and associated with encouraging results.

CLINICAL LUNG CANCER (2022)

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Article Surgery

Prehabilitation services for people diagnosed with cancer in Scotland-Current practice, barriers and challenges to implementation

Debbie Provan et al.

Summary: This study aimed to investigate the current practice, barriers, and challenges of implementing prehabilitation in cancer patients to support the development of a national framework. Survey results showed that while most respondents perceived prehabilitation as important, there were uncertainties about its definition and lack of knowledge about local services.

SURGEON-JOURNAL OF THE ROYAL COLLEGES OF SURGEONS OF EDINBURGH AND IRELAND (2022)

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Article Oncology

Implementation of prehabilitation in colorectal cancer surgery: qualitative research on how to strengthen facilitators and overcome barriers

Thea C. Heil et al.

Summary: This study aims to explore the perspectives of healthcare professionals involved in prehabilitation for patients with colorectal cancer, with the goal of understanding the barriers and facilitators to its implementation and identifying strategies for successful operationalization. Important barriers include conflicting scientific evidence, the inability to offer personalized programs, complex logistical organization, and lack of awareness among healthcare professionals and patients. Relevant facilitators include program coordinators, physician leadership, and involving skeptical colleagues in the implementation process.

SUPPORTIVE CARE IN CANCER (2022)

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Article Medicine, General & Internal

Effect of Prehabilitation Before Total Knee Replacement for Knee Osteoarthritis on Functional Outcomes A Randomized Clinical Trial

Christelle Nguyen et al.

Summary: This study compared the effects of multidisciplinary prehabilitation and usual care on functional independence and activity limitations in patients undergoing total knee replacement surgery for osteoarthritis. The results showed that multidisciplinary prehabilitation did not improve short-term functional independence or reduce activity limitations in the midterm after surgery.

JAMA NETWORK OPEN (2022)

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Article Medicine, Research & Experimental

Prehabilitation of elderly frail or pre-frail patients prior to elective surgery (PRAEP-GO): study protocol for a randomized, controlled, outcome assessor-blinded trial

Stefan J. Schaller et al.

Summary: Frailty is common in older surgical patients and can lead to complications and a limited recovery. Prehabilitation has been shown to improve patients' physiological reserves and reduce care dependency.

TRIALS (2022)

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Review Oncology

Cancer Prehabilitation in Practice: the Current Evidence

Danielle Coderre et al.

Summary: This article reviews recent controversies in cancer prehabilitation, including efficacy, dose, cost effectiveness, stakeholder input, and international implementation. Recent findings suggest that high intensity exercise is recommended and patients are interested in and willing to attend cancer prehabilitation.

CURRENT ONCOLOGY REPORTS (2022)

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Article Anesthesiology

From Theory to Practice: An International Approach to Establishing Prehabilitation Programmes

June F. Davis et al.

Summary: This article emphasizes the importance of prehabilitation in people with cancer and the known and hypothesized benefits. It explores the principles for developing such services in the absence of a single accepted model. The authors describe their experiences and perspectives on the development and implementation of prehabilitation in Canada, the Netherlands, and the United Kingdom, and provide practical tips for others. They also outline important elements for success, such as collaboration with stakeholders, systematic data collection, and adaptation to local situations.

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Article Surgery

Two-year Outcomes of Prehabilitation Among Obese Patients With Ventral Hernias A Randomized Controlled Trial (NCT02365194)

Karla Bernardi et al.

Summary: There is no difference in 2-year outcomes of obese patients seeking ventral hernia repair who undergo preoperative nutritional counseling and exercise (prehabilitation) versus standard counseling.

ANNALS OF SURGERY (2022)

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Article Anesthesiology

Is the Integration of Prehabilitation into Routine Clinical Practice Financially Viable? A Financial Projection Analysis

Maggie M. Z. Chen et al.

Summary: This article provides financial projections and cost-benefit analysis of clinically integrated prehabilitation, showing a net positive cost-benefit attributed to reduced costs associated with surgical morbidity. The engagement of healthcare system and timely referrals play a significant role in the viability of prehabilitation. Further research and formal program evaluations are needed to definitively support the integration of prehabilitation as a standard of care in clinical practice.

CURRENT ANESTHESIOLOGY REPORTS (2022)

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Article Gastroenterology & Hepatology

Adherence to Pre-operative Exercise and the Response to Prehabilitation in Oesophageal Cancer Patients

Laura J. Halliday et al.

Summary: Prehabilitation can help maintain cardiorespiratory fitness in oesophageal cancer patients during neoadjuvant chemotherapy and lead to an increase in fitness before surgery. Adherence to the exercise program and weekly physical activity levels play roles in the effectiveness of prehabilitation, with higher exercise volumes associated with a reduced risk of post-operative pneumonia.

JOURNAL OF GASTROINTESTINAL SURGERY (2021)

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Article Mathematical & Computational Biology

Risk-of-bias VISualization (robvis): An R package and Shiny web app for visualizing risk-of-bias assessments

Luke A. McGuinness et al.

Summary: Despite the availability of numerous software options for evidence synthesis, there is currently no universal tool for generating figures to display and explore risk-of-bias assessments. However, tools such as the R programming environment and Shiny have made it easy to create new tools for producing evidence syntheses. The new tool robvis facilitates the rapid production of publication-quality risk-of-bias assessment figures and is available as an R package and web app.

RESEARCH SYNTHESIS METHODS (2021)

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Article Oncology

From preoperative assessment to preoperative optimization of frail older patiens

Francesco Carli et al.

Summary: As age increases, physiological and mental reserves decrease, making surgery a burden for frail and sarcopenic patients. Preoperative assessment and preparation, similar to training for a marathon, are crucial in improving outcomes for older patients. Prehabilitation can enhance physiological reserve and benefit high-risk patients with chronic conditions.

EJSO (2021)

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Review Gastroenterology & Hepatology

Neoadjuvant treatment: A window of opportunity for nutritional prehabilitation in patients with pancreatic ductal adenocarcinoma

Ilaria Trestini et al.

Summary: PDAC patients often present with advanced disease at diagnosis, with NAT becoming the standard of care but increasing the risk of nutritional decline. Data on prehabilitation in NAT patients are scarce, and nutritional management and prehabilitation programs may have important implications for PDAC patient outcomes.

WORLD JOURNAL OF GASTROINTESTINAL SURGERY (2021)

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Article Health Care Sciences & Services

Evidence-Based Research Series-Paper 1: What Evidence-Based Research is and why is it important?

Karen A. Robinson et al.

Summary: Evidence-based research aims to minimize unnecessary and irrelevant studies by using prior research to guide new studies. This systematic and transparent approach ensures that valuable questions are answered effectively. The method helps to reduce research waste and improve scientific rigor.

JOURNAL OF CLINICAL EPIDEMIOLOGY (2021)

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Article Surgery

Association of a prehabilitation program with anxiety and depression before colorectal surgery: a post hoc analysis of the pERACS randomized controlled trial

Anas Taha et al.

Summary: In a single-blinded randomized controlled trial, the study investigated the impact of a prehabilitation program on preoperative anxiety and depression levels in patients undergoing colorectal surgery. The results showed that prehabilitation did not significantly affect the reduction of anxiety and depression before surgery, and the clinical improvement in anxiety and depression was similar between the prehabilitation and control groups.

LANGENBECKS ARCHIVES OF SURGERY (2021)

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Article Economics

Critical Appraisal of Systematic Reviews With Costs and Cost-Effectiveness Outcomes: An ISPOR Good Practices Task Force Report

Olena (Lena) Mandrik et al.

VALUE IN HEALTH (2021)

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Review Medicine, General & Internal

PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews

Matthew J. Page et al.

Summary: The methods and results of systematic reviews should be reported in sufficient detail to allow users to assess trustworthiness. PRISMA 2020 aims to improve the transparency and completeness of systematic review reporting, in hopes of guiding more accurate and transparent reporting.

BMJ-BRITISH MEDICAL JOURNAL (2021)

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Review Medicine, General & Internal

The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

Matthew J. Page et al.

Summary: The PRISMA statement was designed to help systematic reviewers transparently report the purpose, methods, and findings of their reviews. The updated PRISMA 2020 statement includes new reporting guidance, a 27-item checklist, an abstract checklist, and revised flow diagrams for reviews.

BMJ-BRITISH MEDICAL JOURNAL (2021)

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Article Oncology

Prehabilitation for medically frail patients undergoing surgery for epithelial ovarian cancer: a cost-effectiveness analysis

Jhalak Dholakia et al.

Summary: The study assessed the potential cost-effectiveness of prehabilitation in medically frail patients undergoing surgery for EOC, finding that prehabilitation was not only more effective but also cost-saving, by reducing complication rates and decreasing care facility requirements to save healthcare costs.

JOURNAL OF GYNECOLOGIC ONCOLOGY (2021)

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Review Medicine, General & Internal

Pre-admission interventions (prehabilitation) to improve outcome after major elective surgery: a systematic review and meta-analysis

Rachel Perry et al.

Summary: Some prehabilitation interventions may reduce postoperative length of stay and complications, but the quality of evidence is low.

BMJ OPEN (2021)

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The Role of Behavioral Science in Personalized Multimodal Prehabilitation in Cancer

Chloe Grimmett et al.

Summary: Multimodal prehabilitation plays an important role in oncology by optimizing patients' physical and psychological health through tailored interventions. However, current literature primarily focuses on physiological outcomes with little consideration for behavioral science, highlighting the need for further research on health behavior change and patient engagement.

FRONTIERS IN PSYCHOLOGY (2021)

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Article Rehabilitation

Pre-operative physiotherapy following unilateral ankle fractures at a tertiary hospital in South Africa: Perceptions of patients and nurses

Sabeeha Dangor et al.

Summary: This study explored the perceptions of patients receiving pre-operative physiotherapy care following an ankle fracture and nursing staff managing these patients. The perceived benefits of pre-operative physiotherapy included improved functional independence and reduced burden of care for nurses. However, nurses identified organizational limitations as inhibitors to pre-operative physiotherapy and continuity of care.

SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY (2021)

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Article Oncology

I am busy surviving - Views about physical exercise in older adults scheduled for colorectal cancer surgery

Carla S. Agasi-Idenburg et al.

JOURNAL OF GERIATRIC ONCOLOGY (2020)

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Article Rehabilitation

The effects of preoperative balance training on balance and functional outcome after total knee replacement: a randomized controlled trial

Jose-Maria Blasco et al.

CLINICAL REHABILITATION (2020)

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How Soon Should Patients With Colon Cancer Undergo Definitive Resection?

Robert J. Kucejko et al.

DISEASES OF THE COLON & RECTUM (2020)

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Multimodal prehabilitation as a promising strategy for preventing physical deconditioning on the heart transplant waiting list

Elena Gimeno-Santos et al.

EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY (2020)

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Framework for prehabilitation services

A. Bates et al.

BRITISH JOURNAL OF SURGERY (2020)

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Statewide Prehabilitation Program and Episode Payment in Medicare Beneficiaries

Charles A. Mouch et al.

JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS (2020)

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Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline

Mhairi Campbell et al.

BMJ-BRITISH MEDICAL JOURNAL (2020)

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Preoperative exercise to improve fitness in patients undergoing complex surgery for cancer of the lung or oesophagus (PRE-HIIT): protocol for a randomized controlled trial

Grainne Sheill et al.

BMC CANCER (2020)

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Cost-effectiveness of a technology-supported multimodal prehabilitation program in moderate-to-high risk patients undergoing lung cancer resection: randomized controlled trial protocol

Anael Barberan-Garcia et al.

BMC HEALTH SERVICES RESEARCH (2020)

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Cost-utility analysis of multimodal occupational therapy in patients with thumb base osteoarthritis

A. Tveter et al.

OSTEOARTHRITIS AND CARTILAGE (2020)

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A combination of enhanced recovery after surgery and prehabilitation pathways improves perioperative outcomes and costs for robotic radical prostatectomy

Guillaume Ploussard et al.

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Reporting guidelines of health research studies are frequently used inappropriately

Lisa Caulley et al.

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Prehabilitation Program Improves Outcomes of Patients Undergoing Elective Liver Resection

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Long-term outcomes of major abdominal surgery and postoperative delirium after multimodal prehabilitation of older patients

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Miquel Coca-Martinez et al.

BMJ OPEN (2020)

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Cost-effectiveness of prehabilitation prior to elective surgery compared to usual preoperative care: protocol for a systematic review of economic evaluations

Tanja Rombey et al.

BMJ OPEN (2020)

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Multimodal prehabilitation in colorectal cancer patients to improve functional capacity and reduce postoperative complications: the first international randomized controlled trial for multimodal prehabilitation

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Better before-better after: efficacy of prehabilitation for older patients with osteoarthritis awaiting total hip replacement-a study protocol for a randomised controlled trial in South-Eastern Norway

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BMJ OPEN (2019)

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The effects of prehabilitation versus usual care to reduce postoperative complications in high-risk patients with colorectal cancer or dysplasia scheduled for elective colorectal resection: study protocol of a randomized controlled trial

Annefleur E. M. Berkel et al.

BMC GASTROENTEROLOGY (2018)

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Vanessa Ferreira et al.

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PREHAB study: a protocol for a prospective randomised clinical trial of exercise therapy for people living with frailty having cancer surgery

Daniel I. McIsaac et al.

BMJ OPEN (2018)

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Mike K. Liang et al.

ANNALS OF SURGERY (2018)

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