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How Prehabilitation Can Improve Outcomes and Reduce Hospital Costs

Doug Desjardins for HealthLeaders Media, August 14, 2013

Better preparing cancer patients for surgery and the rigors of treatment regimens can improve patient outcomes and generate cost savings through shorter hospital stays and fewer readmissions, researchers say.

A study published in the August issue of the American Journal of Physical Medicine & Rehabilitation points to the results of several recent pilot programs involving cancer patients that show prehabilitation programs helped patients recover more quickly from surgeries and pursue follow-up care. The study suggests that taking advantage of a small "window of opportunity" before surgery can "improve patient outcomes and reduce direct and indirect healthcare costs."

"There's a long history of using prehabilitation in other settings such orthopedic surgeries and heart bypass surgeries," said Julie K. Silver, MD, an associate professor at Harvard Medical School and co-author of the study titled Cancer Prehabilitation: An Opportunity to Decrease Treatment-Related Morbidity, Increase Cancer Treatment Options, and Improve Physical and Psychological Health Outcomes. "And our review shows there's a great opportunity to use prehabilitation to improve health outcomes for cancer patients as well."

Silver says the concept of prehabilitation has been around for decades, dating back to a 1946 pilot program in which 85% of 12,000 formerly substandard military recruits were able to pass recruitment exams after a two-month improvement program. More recently, a study of patients undergoing knee replacement surgery showed patients who exercised before their surgery recovered more quickly and had fewer complications than those who didn't exercise.

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1 comments on "How Prehabilitation Can Improve Outcomes and Reduce Hospital Costs"


Lea Ann Webb (8/19/2013 at 11:11 PM)
From a patient perspective I will say that even introducing the respiratory therapy prior to surgery required of all patients after general anesthesia prior to would be great. In pain and medicated is not an opportune time to learn anything new. Practicing the therapy in advance and deciding how to keep up with the required # of times performed per day would be a great help. When my son had acl reconstruction he was an athlete and therefore needed to shorten his recovery time as much as possible so he was prescribed prehab. He cycled and performed other exercises at the rehab facility and his surgery was not scheduled until his thigh circumference was equal to his non injured leg. My husband has done well since his robot assisted prostatectomy, but he never took the after surgery exercises very seriously. A female patient would have better understood the exercises, because most women know about kagel exercises. Again, after surgery was not the opportune time to learn A new exercise. His surgeon did require him to prehab by walking every day and losing 2 inches of waist circumference. We had carefully chosen the surgeon and it is the only time my husband has ever followed the exercise and diet recommendations of any MD. So yes, any small improvements in this area would be helpful!