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Need for Comprehensive Economic Evaluation of Prehabilitation Programs Revealed

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A systematic review was carried out to gather and summarize the economic assessments of prehabilitation implementations that currently exist. The potential benefits of prehabilitation, which involves enhancing a patient’s physical and psychological state before surgery, have been noted. Nevertheless, an extensive economic examination of these initiatives is missing.

The PRISMA Protocols 2015 checklist was utilized in this analysis. More than 16,000 manuscripts were reviewed, and 99 reports on preoperative interventions and screening tests were identified. From these reports, 12 studies were selected for this analysis. The costs mentioned in these studies are expressed in Pounds (GBP, £) and adjusted concerning inflation till December 2022.

These studies were primarily conducted in Western countries and focused on particular surgical subspecialties. Even though the interventions and study designs varied, most studies showed cost savings in the intervention group in comparison to the control group. Moreover, all cost-effectiveness analysis studies leaned in favor of the intervention group. Nonetheless, the review also brought to light several limitations.

Prehabilitation

Uncovering the Economic Landscape of Prehabilitation for Surgical Patients

A considerable number of studies had a moderate or high risk of bias. Furthermore, critical information such as time horizons and discount rates were often absent. Key components like heterogeneity, distributional effects, and uncertainty were also frequently missing. The misclassification of economic evaluation types underscored a lack of knowledge among physicians dealing with prehabilitation research.

The review highlights the lack of substantial evidence regarding the economics of prehabilitation programs for surgical patients. This indicates a need for additional research deploying rigorous methods and accurate definitions. The research is expected to provide a more comprehensive understanding of the economic impact of prehabilitation programs.

 

Original Article DOI: 10.3389/fmed.2023.1281843

Original title: Prehabilitation programs – a systematic review of the economic evidence

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