Promoting healthful habits prior to surgery should be just as crucial as any other step in the admittance process. It also could help patients recover more quickly from surgery and reduce costs, according to researchers.
A study published in Surgery notes that “prehab” activities such as fitness and wellness coaching, administered in advance, reduced a surgical patient’s average hospital stay from 7 days to 5 days, when compared to a control group.
It also reduced medical costs by 30%, according to a media release from Michigan Medicine—University of Michigan.
“We do a lot in medicine to get people ready for surgery, but they’re primarily administrative tasks — checking off boxes that don’t necessarily make a patient better,” says Michael Englesbe, MD, a Michigan Medicine transplant surgeon.
“The more you can do to manage your status preoperatively, the quicker you’ll be able to bounce back,” adds, Englesbe, who performed the study along with colleague Stewart Wang, MD, PhD, and others.
A total of 641 patients participated in the study, which followed the Michigan Surgical and Health Optimization Program (MSHOP), an initiative aimed at helping patients target and strengthen weaknesses before surgery. A web-based risk assessment tool using a person’s existing data enabled shared decision-making between patient and physician and helped identify patients who would best benefit from MSHOP.
Elements of the program included improving one’s diet, reducing stress, breathing exercises and smoking cessation, and an emphasis on light physical activity — with the latter reinforced via daily notifications.
Most MSHOP patients were advised to log 12 miles of walking per week, or about an hour a day. Each participant was given a pedometer to track progress, the release explains.
“The vast majority of the program benefits came from the walking,” says Wang, endowed professor of burn surgery and director of the Morphomic Analysis Group at Michigan Medicine.
The MSHOP components can not only boost physical healing, but also provide emotional benefits in the days before the procedure — and, ideally, beyond, the researchers note.
“Patients don’t care about costs or how long they’re going to be in the hospital; they just want to get through the experience,” Englesbe says. “This is an empowering tool that helps them do something positive in the face of a very negative event.”
There is debate among medical professionals regarding the logistics and wider implementation of the MSHOP. However, it has caught the attention of insurance payors that might be able to facilitate a wider reach, according to the release.
“Once it’s a billable service, it will really take off,” Englesbe states.
Since current prehab guidelines are somewhat general, there is room to grow. Someday, the researchers say, the guidelines can be tailored to address more specific scenarios, such as prescribing certain exercises prior to a joint replacement surgery.
“The technology is scalable,” Wang adds. “Expected complications or recovery difficulties could be addressed in advance with targeted training. This is just the beginning.”
[Source(s): Michigan Medicine—University of Michigan, Newswise]
