Personalized teleprehabilitation in elective cardiac surgery: a study protocol of the Digital Cardiac Counselling randomized controlled trial

• Published in: European heart journal. Digital health Vol. 2; no. 3; pp. 477 - 486
• Main Authors: Scheenstra, Bart, Mohansingh, Chanu, Bongers, Bart C, Dahmen, Sandra, Wouters, Yvonne I M S, Lenssen, Ton F, Geerlings, Phil, Knols, Henriette F M, van Kuijk, Sander M J, Kimman, Merel L, Nieman, Maxime, Maessen, Jos G, Van't Hof, Arnoud W J, Peyman, Sardari Nia
• Format: Journal Article
• Language: English
• Published: England 01-09-2021
• Subjects: Teleprehabilitation; Physical fitness; Telehealth; Pre-operative assessment; Prehabilitation; Cardiac events
• ISSN: 2634-3916; 2634-3916
• DOI: 10.1093/ehjdh/ztab041

Previous research has shown the possibility to use the pre-operative period to improve a patient's tolerance for surgery. However, there is limited experience with prehabilitation in cardiac surgery. The aim of this study is to evaluate the effect of a comprehensive personalized teleprehabilitation programme on major adverse cardiac events (MACE) in patients scheduled for elective cardiac surgery. Secondary outcomes are post-operative complications, cardiovascular risk factors, quality of life, and cost-effectiveness.
In this single-centre randomized controlled trial, patients are eligible for inclusion when they are ≥18 years of age and cardiac surgery is scheduled at least 8 weeks from informed consent. Participants will be randomized to the teleprehabilitation group or the control group. After a digital baseline screening for perioperative risk factors, patients in the intervention arm can pre-operatively be referred to one or more of the prehabilitation modules (functional exercise training, inspiratory muscle training, psychological support, nutritional support, and/or smoking cessation). The programme is targeted at a duration of at least 6 weeks. It is executed by a multidisciplinary team using (video)calls and supported by a custom-made digital platform. During the pre-operative period, the platform is also used to inform patients about their upcoming surgery and for telemonitoring.
Reducing perioperative risk factors might result in a reduction of MACE, post-operative complications, length of stay, and cardiovascular risk factors, as well as improved quality of life. Cost-effectiveness will be evaluated.