Grant: Project Grant - Priority Announcement: Patient-Oriented Research

Over half a million Canadians have major surgery (like joint replacements, heart or cancer operations) yearly. Surgery stresses peoples' bodies, much like running a marathon. Unlike runners, who train a lot for their race, most Canadians are not actively preparing for surgery. This means that they may not be in the best possible shape for surgery and may suffer from complications, long hospital stays, or even die. Effective strategies to better prepare people for major surgery are needed. Prehabilitation means preparing for surgery through exercise, nutrition and/or stress management. People are very interested in prehabilitation because it makes sense that preparing people's minds and bodies for surgery will lead to better experiences and outcomes. Unfortunately, research has not always shown these benefits; we think this is because different types of patients need different types of prehabilitation. If we can understand what patient characteristics and what types of prehabilitation programs work best, we can use healthcare resources wisely, use patients' time wisely, and make sure the right patient receives the right care before surgery. We can also direct new research efforts toward the most promising programs and under-served patients. So far, hundreds of individual studies of prehabilitation have been completed, but they have not provided solid answers to questions that matter to patients and clinicians. When research studies have conflicting findings, systematic reviews are important to sort out the reasons why. We will create a long term systematic review that is constantly bringing in newly published studies and use these pooled data to determine: 1) what types of prehabilitation are most effective, 2) what types of patients may benefit most from prehabilitation, and 3) what types of programs and patient factors lead to the highest levels of participation and response.