BARRIERS AND FACILITATORS FOR HEALTHCARE PROFESSIONALS TO IMPLEMENTING A PREHABILITATION PROGRAMME: REVIEW OF THE LITERATURE

Abstract

Background Prehabilitation is the process of optimising the body and mind to be able to cope with the stress of surgery. Whilst the evidence-base for prehabilitation is growing, demonstrating bene ts to patient experience and outcomes, it is not yet a routine part of the surgical pathway. Healthcare professional engagement is key to increasing uptake in practice. The aim of this literature review was to establish what the barriers and facilitators are for healthcare professionals to implementing a prehabilitation program. Methods PubMed, Cochrane, NIHR Journals Library, PEDro and Google Scholar databases were searched with the primary keyword ‘prehabilitation’ with expanded search terms for PubMed and Google Scholar. Studies were eligible for inclusion if they were written in English, involved adults aged >18 years and included healthcare professionals’ views of prehabilitation. Due to different study designs, results were assimilated using thematic analysis, assigning codes to key pieces of text and then grouping codes together to form themes. Results The search returned a total of 625 papers, 10 were examined in detail and 6 studies were included in this review. Across these studies, four key themes were established: lack of knowledge, lack of resources, inconsistencies and patient engagement. Overall study quality was mixed but generally fair, none were rated as high quality. Conclusion Prehabilitation has been shown to bene t patient outcomes, but implementation remains low in practice. Whilst this review has established the barriers for healthcare professionals to implementing prehabilitation, these conclusions are limited by the quality and number of available studies.

Keywords

• prehabilitation
• barriers
• facilitators
• healthcare professionals