The Long-Term Impact of a Teleprehabilitation Programme on Modifiable Risk Factors and Quality of Life After Cardiac Surgery.

OBJECTIVES

To assess the long-term effects of teleprehabilitation on modifiable risk factors and quality of life up to 1 year following elective cardiac surgery.

METHODS

This secondary analysis of the Digital Cardiac Counselling trial, a randomized controlled trial, compared multimodal teleprehabilitation with standard care in patients undergoing elective cardiac surgery. The teleprehabilitation programme targeted physical fitness, inspiratory muscle training, psychological support, nutritional optimization, and smoking cessation. Outcomes included trajectories of modifiable risk factors and quality of life measured preoperatively and at 3, 6, and 12 months postoperatively. Generalized linear mixed models assessed differences over time between groups, with exploratory post hoc analyses for individual timepoints.

RESULTS

Both groups showed postoperative reductions in all assessed modifiable risk factors and improvements in quality of life over time (P < .001), except for nutritional optimization (P = .173). Teleprehabilitation was associated with more favourable trajectories for smoking behaviour (P = .045) and nutritional risk (P = .011), with consistently lower incidences throughout follow-up. Smoking prevalence remained significantly lower in the teleprehabilitation group at all timepoints (P < .05), while malnutrition prevalence was lower at 3 months postoperatively (P = .012). Quality-of-life scores were consistently higher in the teleprehabilitation group throughout follow-up (P = .002).

CONCLUSIONS

Teleprehabilitation in cardiac surgery patients not only reduces postoperative complications, but may also provide additional long-term benefits, particularly in smoking cessation, nutritional optimization, and quality of life. These findings support teleprehabilitation as a valuable addition to standard preoperative care, with possible sustained benefits for long-term lifestyle and quality of life.