Prehabilitation - improving the fitness of patients for surgery

Title: Preparing For Surgery: The Community Prehabilitation and Wellbeing Project (The PREP-WELL Project) 

Funder: The Health Foundation – Innovating for Improvement, Sport England 

DSER staff: Dr Garry Tew 

Collaborators: Dr Joanne Gray, Northumbria University; South Tees Hospitals NHS Foundation Trust, Public Health (Middlesbrough and Redcar and Cleveland), South Tees Clinical Commissioning Group, University of York 

Adverse lifestyle choices such as sedentary behaviour, poor diet, smoking and hazardous drinking are associated with poor outcomes following surgery, reduced longer-term survival and increased healthcare costs. 

Through this quality improvement project, we plan to introduce a new, community-based service for patients preoperatively, to capitalise on the ‘teachable moment’ of impending surgery to encourage behaviour modification. We will use validated comprehensive assessments to create supervised patient-centred management plans around lifestyle and education. The aim is to help patients to improve their fitness for surgery and achieve meaningful long-term lifestyle benefits. 

Project website

University webpage

Find out more: 

Tew, G. A., Ayyash, R., Durrand, J., & Danjoux, G. R. (2018). Clinical guideline and recommendations on pre‐operative exercise training in patients awaiting major non‐cardiac surgery. Anaesthesia, 73(6), 750-768. 

Tew, G. A., Batterham, A. M., Colling, K., Gray, J., Kerr, K., Kothmann, E., ... & Danjoux, G. (2017). Randomized feasibility trial of high‐intensity interval training before elective abdominal aortic aneurysm repair. British Journal of Surgery, 104(13), 1791-1801. 

Weston, M., Batterham, A. M., Tew, G. A., Kothmann, E., Kerr, K., Nawaz, S., ... & Danjoux, G. (2017). Patients awaiting surgical repair for large abdominal aortic aneurysms can exercise at moderate to hard intensities with a low risk of adverse events. Frontiers in physiology, 7, 684. 

Tew, G.A., Bedford, R., Carr, E., Durrand, J.W., Gray, J., Hackett, R., Lloyd, S., Peacock, S., Taylor, S., Yates, D. and Danjoux, G., 2020. Community-based prehabilitation before elective major surgery: the PREP-WELL quality improvement project. BMJ Open Quality, 9(1), e000898.