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

Over a million Canadians have major surgery (like joint replacements, heart or cancer surgery) yearly. Surgery stresses people's bodies, much like running a marathon. Unlike runners, who train 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 stay, 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. When research studies have conflicting findings, systematic reviews are important to sort out the reasons why. Hundreds of individual studies of prehabilitation have been completed, but they have not provided solid answers to questions that matter to patients and clinicians. We will complete a systematic review of all prehabilitation randomized trials and use this pooled data to determine: 1) what types of prehabilitation are most effective, 2) what types of patients may benefit most from prehabilitation, 3) what the main technical limitations in prehabilitation research have been so far, and 4) what roles patients have, and should play in shaping prehabilitation research.