EBPOM 2019 | Multimodal prehabilitation to prevent postoperative delerium and other complications in elderly patients after elective major abdominal surgery.

Can delirium, the most frequent complication in an elderly patient, be tackled with multimodal prehabilitation? This piece explains how that challenge is being investigated at the moment. A link to the paper is here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6564537/ Presented by Ties Lukas Janssen, General Surgery Resident at Amphia Ziekenhuis.

EBPOM 2019 | System wide change for prehabilitation

Should prehabilitation be thought of also as “primary prevention” and used to avoid health problems occuring in the first place? If “exercise is real medicine” how do we change the culture so GPs are comfortable prescribing physical activity to patients? How can we get people to exercise more when the political mood is turning against Government interference and the so-called “nanny state”? What is ‘the business case’ for prehabilitation? Co-chaired by Mike Grocott and Stefan van Rooijen and featuring: Graciela Martinez-Palli, Consultant in the Department of Anaesthesia and Perioperative Care at Hospital Clinic, Barcelona; Anna Lowe, Programme manager, National Centre for Sport and Exercise Medicine, Lead Allied Health Physical Activity Clinical Champion at Public Health, England; John Moore, Clinical Head of the Division of Anaesthetics, Peri-operative medicine and Critical Care at Manchester University Hospital NHS Foundation Trust; Sarah Ruane, Sport England’s national lead for health, she joined in January 2016 from local government where she oversaw public health, leisure and cultural services.

EBPOM 2019 | Prehabilitation and Perioperative Care, panel discussion

This panel discussion reacts to various questions from the online audience and those in attendance. Questions include; Is there any good evidence for the use of wearable tech in prehabilitation? How come, if the evidence is almost there, prehabilitation is not yet included in every pathway? In this respect, is change just around the corner? How do we have patients are partners rather than passive participants? What are the benefits of prehabilitation which can be seen in two weeks? How does one go about setting up a streamlined preoperative service? What would be the most important outcome for any prehabilitation trial? In a usually sedintary patient, how do we engage them in exercise training and prehabilitation? Featuring; Mike Grocott, Professor of Anaesthesia and Critical Care Medicine, University of Southampton, Franco Carli Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University, Staff anesthesiologist at the McGill University Health Centre and June Davis; June has 22 years of experience working in the NHS as a Dietitian, service and professional lead, general manager for a number of service areas within the acute setting and senior project lead for several large scale change projects across London; 10 years experience working as Head of Therapies for large acute Trusts. She is also a Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission.

EBPOM 2019 | Prehabilitation and cancer

This piece starts with some words from patients; prehabilitation is “a set of actions that can be taken in advance of treatment to ease your passage through cancer”. This vital talk explains how prehabilitation can leave cancer patients feeling personally empowered and ready to live well. Living is one thing, how do we get people to enjoy ‘living well’? Further to this how do we do that in such a way that respects patient decisions and life choices? How can we get to a position where exercise, nutrition and psychological support are integral to a cancer diagnosis? Ideally prehabilitation gets to a point where all patients feel like the ones quoted in this talk; “It’s a win win situation […] do that and you’ll be healthier”. Presented by June Davis; June has 22 years of experience working in the NHS as a Dietician, service and professional lead, general manager for a number of service areas within the acute setting and senior project lead for several large scale change projects across London; 10 years experience working as Head of Therapies for large acute Trusts. She is also a Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission.

EBPOM Highlight | Exercise prehabilitation for patients facing primary surgical resection of colorectal cancer

This piece is taken from the free papers presentations given at EBPOM 2019. Can two weeks of prehabilitation really make a difference for patients facing primary surgical resection of colorectal cancer? How feasable is it to recruit patients into such a programme? Can we make a real change in their objectively measured fitness? Is there patient buy in? What is the strain on an institution’s resources? Presented by Andrew Bates, Senior Research Nurse at Royal Bournemouth Hospital NIHR Intern.

ANES19 | Prehabilitation with Mike Grocott

The TopMedTalk team are live from Anesthesiology 2019 at the Orange County Convention Center in Orlando. With over 14,000 delegates, clinicians, thought leaders and professionals, it’s the largest gathering of Anesthesiologists and Anesthesia providers in the world. Check out the www.topmedtalk.com website now to hear live audio, while you are there remember to subscribe for updates so you can always be one step ahead of the crowd. Also, if you fancy watching the show as it happens go to our Twitter feed www.twitter.com/topmedtalk to see the team in action. This piece tackles “prehabilitation”, TopMedTalk’s word of the year. What is it, why is it so important, who is doing it and why are some people reticent about something that is so obviously good for their health? Furthermore, what are the transatlantic nuances to this debate? Presented by Desiree Chappell with Sol Aronson, tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology, and their guest Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton. — Like this, want more? Sol Aronson’s excellent talk “EBPOM 2018| Perioperative medicine is Population Health Management” is here: https://www.topmedtalk.com/ebpom-2018-perioperative-medicine-is-population-health-management/ And Mike Grocott co-chair’s a gripping debate about prehabilitation, “EBPOM 2019 | System wide change for prehabilitation”, is here: https://www.topmedtalk.com/ebpom-2019-system-wide-change-for-prehabilitation/

EBPOM Highlight | Prehabilitation

Prehabilitation represents a real opportunity for practitioners to exploit a ‘teachable moment’ and realise long term positive behavioural changes. Making patients ‘partners in their own care’ is an essential part of this, with prehabilitation they have a chance to work with practitioners to increase their functional reserve, increase their rate of recovery and avoid difficult long term outcomes. The longer this partnership lasts the more effective it is. In this respect, how do we manage to emphasise the importance of early access to patients? The evidence of the benefits of exercise is overwhelming, even just two weeks of activity can make a huge difference, how do we articulate this to patients? How much focus should there be on nutrition? Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care, Consultant in Perioperative Medicine, Southampton University Hospital NHS Foundation trust (UHS), President of the Perioperative Exercise Testing and Training Society (POETTS).

EBPOM 2019 | Prehabilitation: how far have we come?

“The father of prehabilitation” reflects on where the discipline is now and where it used to be, from new kid on the block to being touted now as the word of the moment. How has this change come about? Is it the focus value based care? Is it the fact we’re becoming more patient focused? Is it fair to say this is an evidence led focus brought about by more information and understanding regarding long term patient outcomes? Further discussion includes frailty, engaging patients in their prehabilitation and educating patients. This talk gives a wealth of powerful practical techniques which will help you to continue to provide the sort of high quality healthcare your patients and institutions expect. This piece gives you a fantastic overview alongside some interesting insights and suggestions as to what the future might hold and where things can be improved. Presented by Franco Carli, Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University, Staff anesthesiologist at the McGill University Health Centre.

High-Intensity Interval Training and the future of experimental medicine | EBPOM 24

Recorded exclusively at this year’s Evidence Based Perioperative Medicine (EBPOM) World Congress in London this piece looks in detail at High-Intensity Interval Training (HIIT). HIIT can significantly enhance physical fitness and resilience in cancer patients, reducing complications and improving quality of life. Hear how HIIT can positively impact mitochondrial performance, thus improving cardio-respiratory fitness. The discussion also explores the integration of experimental medicine from bench to bedside, emphasizing the multidisciplinary approach involving surgeons, scientists, and anesthetists. Presented by Andy Cumpstey and Joff Lacey with their guests Colleen Dean, Lecturer in Muscle Cell Biology and Malcolm West, Associate Professor in Colorectal Surgery and Prehabilitation Medicine at the University of Southampton, an honorary appointment as a consultant colorectal and complex cancer surgeon at University Hospitals Southampton NHS Foundation Trust.

EBPOM 2023 IS THIS WEEK – GO TO EBPOM.ORG NOW!

This week we are drawing attention to an excellent talk from our archive and warming up for the biggest moment in the perioperative calendar; Evidence Based Perioperative Medicine (EBPOM) and the World Congress of Prehabilitation Medicine 2023. Go now to www.ebpom.org to book your virtual tickets, if you can’t make it in person. In this podcast we look at some of the upcoming sessions and reflect on the contributions made previously to TopMedTalk by some of the panelists and speakers. We discuss this episode of TopMedTalk featuring Gerrit Slooter & Mike Grocott – https://topmedtalk.libsyn.com/the-international-prehabilitation-and-perioperative-exercise-testing-society-ipoetts-ebpom-world-conference We mention the fact that Franco Carli makes important contributions during to this panel discussion: Exercise and the cancer patient during the COVID-19 crisis: https://topmedtalk.libsyn.com/exercise-and-the-cancer-patient-during-the-covid-19-crisis-ebpom-2021 Feras Hatib features in the 2019 Prehabilitation World Congress here: Prehab Periop World Congress: Feras Hatib, Simon Davies https://topmedtalk.libsyn.com/prehab-periop-world-congress-feras-hatib-simon-davies And “Nutrition and surgery a dieticians perspective” with Chelsia Gillis is here: https://topmedtalk.libsyn.com/ebpom-2019-nutrition-and-surgery-a-dieticians-perspective-0 Meanwhile the talk in this week’s podcast, from 2018, Sir Bruce Keogh features here in it’s original form: https://topmedtalk.libsyn.com/the-topmedtalk-top-ten-sir-bruce-keogh-the-nhs-at-70