Does a Digital Prehabilitation Solution Informed by Evidence-Based Interventions Reduce the Healthcare Burden and Improve Outcomes for Patients Awaiting Cardiac Surgery?—A Systematic Review

BACKGROUND AND AIMS: Prehabilitation before cardiac surgery targets modifiable risk factors to enhance surgical readiness and recovery. It can reduce complications, mortality, and hospital stay; however, remains underused in routine cardiac care. As digital health gains traction, remote delivery of prehabilitation offers a promising way to expand access and equity to cardiac patients. This review examines the delivery, outcomes, and effectiveness of digital prehabilitation for adults awaiting cardiac surgery. METHOD: This review followed the Preferred Reporting Items of Systematic Reviews and Meta-Analyses Analyses 2020 guidelines and was registered with PROSPERO (ID: 452250). Seven databases were searched, identifying studies which evaluated digital prehabilitation in cardiac surgery patients. Screening, selection, and data extraction were performed, and outcomes were categorised by feasibility, health outcomes, and healthcare utilisation. RESULTS: Analysis showed significant findings in favour of digital prehabilitation over standard care in terms of feasibility, efficacy, complications, and costs/healthcare utilisation. Interrogation of the results data via meta-analysis was unsuitable due to the heterogeneity of the methodologies and evaluation time points. CONCLUSIONS: Digital prehabilitation is a safe, feasible and potentially effective strategy to improve outcomes and reduce healthcare burden in cardiac surgery.