Prehabilitation

Abstract

In this article, we review the evidence underpinning the broader prehabilitation concept and the target behavioural and lifestyle risk factors including their perioperative impact and evidence for prehabilitation intervention. We also identify principles for delivering prehabilitation in practice, alongside lessons for the perioperative setting from well-established allied interventions; cardiac and pulmonary rehabilitation.

Making every contact count: the role of the clinician in smoking cessation during the perioperative period

“…Editor -Butterworth and colleagues highlight the problems of recruiting and retaining enough medical trainees. 1 They also mention there is a similar crisis in general practice. As medical students who were recently encouraged to become general practitioners (GPs) by conducting quality improvement projects in primary care, we would like to share what we learned.…”

“…2.3 Editor -We read the paper by Durrand et al about setting up prehabilitation services with interest and would like to highlight our learning and insight from a local smoking cessation service for perioperative patients. 1 Smoking is an independent predictor of postoperative complications, and modifications have shown to improve outcomes after surgery. 2 The perioperative period can be an auspicious time to address risk-taking behaviours, like smoking, as patients may be more receptive to making positive changes that can impact their health.…”

“…2 The perioperative period can be an auspicious time to address risk-taking behaviours, like smoking, as patients may be more receptive to making positive changes that can impact their health. 1 Clinicians can play an important role in patient behavioural change by using strategies like Making Every Contact Count (MECC). 1,3 Smoking has been recognised as the main cause of preventable illness and premature mortality in England and is associated with increased perioperative risk and delayed postoperative recovery.…”

“…1 Clinicians can play an important role in patient behavioural change by using strategies like Making Every Contact Count (MECC). 1,3 Smoking has been recognised as the main cause of preventable illness and premature mortality in England and is associated with increased perioperative risk and delayed postoperative recovery. 4,5 Smoking cessation advice and referral has been shown to be cost effective in helping people quit and is an intervention that lends itself well to MECC.…”

Progress requires change from the norm

“…The material is wide ranging: there are articles that will be of great help the medical registrar (perioperative diabetic care, opioid management, management of surgery in frail individuals) as well as manuscripts to help with system design (in the context of integrated care systems, 'prehabilitation' initiatives, shared decision making). [1][2][3][4][5][6] The content has been invited and carefully curated by Dorian Martinez, James Goodwin, David Selwyn and many others from the RCoA who, along with the authors, deserve all the credit for this issue.…”