Reasons and predictors of non-participation in a personalized digital prehabilitation care trial for patients undergoing elective cardiothoracic surgery

Bart Scheenstra, Bart C Bongers, Britney Broeders, Maike Imkamp, Lieke Van Susante, Bas Kietselaer, Jos Maessen, Arnoud Van 't Hof, Peyman Sardari Nia*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVES: Prehabilitation through a digital platform could preoperatively improve the physical and mental fitness of patients undergoing cardiothoracic surgery, thereby improving treatment outcomes. This study aimed to describe the reasons and predictors of non-participation in a personalized digital prehabilitation care trial (Digital Cardiac Counseling randomized controlled trial) for patients undergoing elective cardiothoracic surgery. METHODS: Adult patients scheduled for elective cardiothoracic surgery at the Maastricht University Medical Center+ were approached to participate in a digital prehabilitation care trial, in which patients were informed about their care pathway, monitored for symptom progression and screened for preoperative modifiable risk factors. Baseline characteristics of all eligible patients and reasons of non-participation were registered prospectively. Predictors of non-participation were determined using logistic regression. RESULTS: Between May 2020 and August 2022, 815 patients were eligible for participation; 421 (52%) did not participate in the personalized digital prehabilitation care trial. Reasons for non-participation were 'lack of internet access or insufficient digital skills' (32%), 'wishing no participation' (39%) and 'other reasons' (30%; e.g. vision or hearing impairments, analphabetism, language barriers). Independent predictors of non-participation were age [odds ratio (OR) 1.024 (1.003-1.046), P?=?0.024], socioeconomic status [OR 0.267 (0.133-0.536), P?<?0.001], current smoker [OR 1.823 (1.124-2.954), P?=?0.015] and EuroSCORE II [OR 1.160 (1.042-1.292), P?=?0.007]. CONCLUSIONS: Half of the eligible patients did not participate in a personalized digital prehabilitation care trial. Non-participants were vulnerable patients, with a more unfavourable risk profile and more modifiable risk factors, who could potentially benefit the most from prehabilitation.
Original languageEnglish
Article number ivad123
Number of pages7
JournalInterdisciplinary CardioVascular and Thoracic Surgery
Volume37
Issue number2
DOIs
Publication statusPublished - 3 Aug 2023

Keywords

  • Cardiothoracic surgery
  • Care pathway
  • Preoperative care
  • Telemonitoring
  • Teleprehabilitation

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