Digital delivery of lifestyle behaviour change in patients requiring cardiac surgery? A scoping exercise focusing on patients and healthcare professionals

Project Description

Patients who have undergone coronary artery bypass graft (CABG) benefit from cardiac rehabilitation (Class 1, Level A evidence). CR is recommended by the WHO, NICE and the NHS. Pre and post operative lifestyle was a high priority, as independently judged by a group of cardiac surgery patients/carers and healthcare providers (Lai et al, 2020). Prehabilitation is delivered whilst patients are awaiting surgery to reduce the incidence and severity of postoperative complications. Transforming surgical waiting lists into preparation pathways may be a highly pragmatic approach for optimising patient outcomes. Core lifestyle components of CR are physical activity and exercise, nutrition, smoking cessation, sleep, psycho-social and alcohol management. A multi-component lifestyle modification conducted in the pre-operative period is likely to elicit clinically significant benefits and lead to improved short and long-term outcomes.

Home-based CR and/or use of digital technologies are becoming popular and may ultimately replace hospital-based CR. Increasing uptake of CR services is clearly important as only 50% accept an offer (not completion) of CR in the UK. For some patients (women, older people, ethnic minorities, and patients with a lower socio-economic status) home and or digital technologies may be an more practical approach to increase CR uptake. It is our opinion that digital technologies (Apps) will be a key tool in this rehabilitative tool kit.