What demographic factors influence participation in a randomised controlled trial on prehabilitation for cardiac surgery?
Refereed conference paper presented and published in conference proceedings


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AbstractBACKGROUND: The ongoing PREQUEL study examines the effect of a hospital-based physical prehabilitation program before cardiac surgery to improve frailty and hence postoperative recovery. The objective of this sub-study was to assess the association between baseline factors and successful study participation.

METHODS: This is a prospective cohort study (ChiCTR1800016098) at a university hospital in Hong Kong. 153 pre-frail and frail patients (Clinical Frailty Scale [CFS] 4-6) who met the eligibility criteria were invited to participate in the trial between July 2018 and March 2020. Non-participants were defined as: inability to regularly attend, or indecisive/refusal to participate. Mobility status was classified as good (independent outdoor walker) or poor (homebound). Driving distance from home to hospital was estimated using Google Maps software. Demographic and baseline clinical data differences between participation groups were analysed using appropriate univariate tests.

RESULTS: There were 81 (52.9%) participants and 72 (47.1%) non-participants during the 21-month period. Study participation groups were similar for mean age (P=0.29), gender (P=0.58), occupation (P=0.27), education level (P=0.84), living alone (P=0.44), regular exercise habits (P=0.24), types of surgery (P=0.73), median frailty level (P=0.42), median left ventricular ejection fraction (P=0.75) and median number of cardiovascular risk factors (P=0.11). Poor mobility status was associated with the study participation, with no homebound participants recruited into the study (P=0.047). Participation rates varied across districts (33-100%) (Figure 1), with 3 patients living across the border. For Hong Kong-based patients, study participants lived closer to the hospital than non-participants (n=150; median [IQR]: 21.8 km [7.5-32.0 km] vs 30.4 km [13.3-34.8 km]; P=0.02). Patients who lived ≤20 km of the hospital were more likely to participate in RCT than those living >20 km away (RR: 1.49, 95% CI: 1.12-1.99).

CONCLUSION: Good mobility status and closer residential distance from the hospital were associated with successful RCT participation. Recruitment strategies that address ambulatory and transport difficulties may increase the participation of patients living far away from the hospital.
Acceptance Date02/06/2020
All Author(s) ListDerek King Wai YAU, Malcolm John UNDERWOOD, Gavin Matthew JOYNT, Anna LEE
Name of ConferenceHong Kong College of Cardiology 28th Annual Scientific Congress
Start Date of Conference03/07/2020
End Date of Conference05/07/2020
Place of ConferenceHong Kong
Country/Region of ConferenceHong Kong
Proceedings TitleJournal of the Hong Kong College of Cardiology
Year2020
Volume Number28
Issue Number1
ISSN1027-7811
LanguagesEnglish-United Kingdom
KeywordsCardiac surgery, Preoperative rehabilitation, Demographic factors

Last updated on 2021-18-02 at 11:07