A UCLA Health study analyzing 20 randomized controlled trials suggests that psychological prehabilitation can reduce hospital stays, pain, anxiety, and depression after surgery.
Researchers at UCLA Health, conducting a new analysis, found that psychological prehabilitation can significantly enhance recovery after surgery.
Study Overview and Methodology
The research, led by Anne E. Hall, BS, in the lab of Justine Lee, MD, PhD, FACS, analyzed data from 20 randomized controlled trials (RCTs) conducted between 2004 and 2024, involving a total of 2,376 patients. It is published in the Annals of Surgery.
Expanding the Scope of Prehabilitation
Prehabilitation is a proactive approach aimed at improving surgical outcomes through preventive measures. Traditionally, it has focused on physical function and patient education. However, mental health has recently gained attention due to its crucial role in postoperative recovery, including reducing persistent opioid use.
Data Sources and Intervention Types
The researchers conducted a systematic review, meta-analysis, and meta-regression of RCTs retrieved from databases such as MEDLINE, EMBASE, CENTRAL, and Google Scholar. They included studies with more than 50 adult surgical patients and evaluated the effects of different preoperative psychotherapy-based interventions, including cognitive behavioral therapy (CBT), supportive psychotherapy, and acceptance and commitment therapy (ACT), on postoperative outcomes.
Key Findings on Postoperative Outcomes
The study found that psychological prehabilitation significantly reduces the length of hospital stay, pain, anxiety, and depression after surgery. Specifically, the analysis showed:
- A reduction in length of hospital stay (LOS) by an average of 1.62 days;
- A decrease in pain by an average of 3.52 points;
- Lower anxiety levels regardless of which validated anxiety scale was used;
- Reduced depression levels regardless of which validated depression scale was used.
Implications and Future Research
The type of psychotherapy and the kind of surgery did not significantly affect the outcomes, except for anxiety, according to the findings.
The researchers suggest that incorporating psychological prehabilitation into pre-surgery routines could lead to better overall recovery for patients. This approach may also help reduce healthcare costs associated with prolonged hospital stays and postoperative complications.
The study’s authors say their findings highlight the need for further research to compare different types, durations, and delivery methods of psychotherapy to determine the most effective strategies for specific postoperative outcomes.
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