Perioperative medicine & outcomes
Adherence to prehabilitation in adult surgical patients: a systematic review, meta-analysis, meta-regression, and qualitative synthesis
Authors' conclusion
Prehabilitation adherence metrics are variable across trials and standardisation is required to improve reporting and interpretation of prehabilitation evidence. Little credible evidence identifies factors associated with adherence; however, qualitative barriers and facilitators could inform programme design and implementation.
Study context
- Population
- Adults undergoing major elective surgery allocated to a prehabilitation programme
- Participants
- 4,941 adults · 105 trials
- Outcome
- Pooled adherence to prehabilitation
Methodological detailsrandom-effects meta-analysis, Theoretical Domains Framework qualitative synthesis, Searched Ovid MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, Cochrane CENTRAL from inception to April 10, 2024
- Random-effects meta-analysis
- Theoretical Domains Framework qualitative synthesis
- Searched Ovid MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, Cochrane CENTRAL from inception to April 10, 2024
Pooled result
As reported in the abstract
Pooled adherence (random-effects meta-analysis)
79%
95% CI 70–88
Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| Predictors of adherence (meta-regression): patient ageOnly factor significantly associated with adherence | 0.95 (0.91–0.99) | |
| 0.512Odds ratio (log scale) |
Definitions of adherence
- Substantial qualitative and statistical heterogeneity in defining prehabilitation adherence
Barriers and facilitators (qualitative synthesis)
- Common barriers: logistical issues and health conditions
- Facilitators: supervision by specialists and personalisation
Original publication
Adherence to prehabilitation in adult surgical patients: a systematic review, meta-analysis, meta-regression, and qualitative synthesis. Br J Anaesth. Published 4 July 2025. doi:10.
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