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

Autor:	Scheenstra B; Department of Cardiothoracic Surgery, Heart and Vascular Center, Maastricht University Medical Center, Maastricht, Netherlands.; Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands., Bongers BC; Department of Nutrition and Movement Sciences, Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands.; Department of Surgery, Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands., Broeders B; Department of Cardiothoracic Surgery, Heart and Vascular Center, Maastricht University Medical Center, Maastricht, Netherlands., Imkamp M; Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, Netherlands., Van Susante L; Department of Cardiothoracic Surgery, Heart and Vascular Center, Maastricht University Medical Center, Maastricht, Netherlands., Kietselaer B; Department of Cardiovascular Disease, Mayo Clinic, Rochester, MN, USA., Maessen J; Department of Cardiothoracic Surgery, Heart and Vascular Center, Maastricht University Medical Center, Maastricht, Netherlands.; Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands., Van 't Hof A; Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands.; Department of Cardiology, Heart and Vascular Center, Maastricht University Medical Center, Maastricht, Netherlands.; Department of Cardiology, Zuyderland Medical Center, Heerlen, Netherlands., Sardari Nia P; Department of Cardiothoracic Surgery, Heart and Vascular Center, Maastricht University Medical Center, Maastricht, Netherlands.; Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands.
Jazyk:	angličtina
Zdroj:	Interdisciplinary cardiovascular and thoracic surgery [Interdiscip Cardiovasc Thorac Surg] 2023 Aug 03; Vol. 37 (2).
DOI:	10.1093/icvts/ivad123
Abstrakt:	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. (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu