"Prehabilitation" prior to CABG surgery improves physical functioning and depression.

Area of Science:

• Cardiology
• Psychology
• Health Economics

Background:

• Patients awaiting coronary artery bypass graft (CABG) surgery often experience psychological distress and reduced physical activity.
• Routine care may not adequately address these pre-operative challenges.

Purpose of the Study:

• To evaluate the effectiveness of the HeartOp Programme, a brief cognitive-behavioural intervention, when added to standard nurse counselling for patients awaiting CABG.
• To assess the impact on psychological distress, physical functioning, and cost-effectiveness.

Main Methods:

• A randomized controlled trial involving 204 patients undergoing first-time elective CABG.
• Intervention group received nurse counselling plus the HeartOp Programme; control group received routine nurse counselling.
• Primary outcomes included anxiety and length of hospital stay; secondary outcomes included depression, physical functioning, and cardiac misconceptions.

Main Results:

• No significant differences were observed in anxiety or length of hospital stay between groups.
• The HeartOp Programme group showed significant improvements in depression, physical functioning, and reduced cardiac misconceptions compared to the control group.
• Only reduced cardiac misconceptions were maintained post-surgery. The Incremental Cost Effectiveness Ratio (ICER) was £288.83 per Quality-Adjusted Life Year.

Conclusions:

• The HeartOp Programme, combined with nurse counselling, offers significant benefits for patients awaiting CABG surgery.
• It effectively reduces pre-operative depression, improves physical functioning, and corrects cardiac misconceptions.
• The intervention demonstrates cost-efficacy, meeting accepted criteria for healthcare economics.