7 A multi-centre randomised controlled trial of standard care versus an accelerated care pathway after cardiac surgery (FARSTER-care)

<h3>Background</h3> Following cardiac surgery the current practice is for patients to attend their first outpatient review approximately six weeks post-surgery and then cardiac rehabilitation (CR) is started from eight weeks. These timeframes are not evidence-based and may prolong recovery after surgery. By placing unnecessary limitation on patient activity, it extends the period of vulnerability. Patients often seek medical attention for surgery-related complications during this period. Early initiation and progressive physical exercise after cardiac surgery have well known benefits. Our feasibility study established that bringing forward outpatient review and CR, in order to facilitate recovery, physical fitness and Quality of Life was acceptable to patients, and that a full scale RCT (Randomised Controlled Trial) was feasible. <h3>Aim</h3> To determine if early specialist outpatient review and commencement of CR leads to improved outcomes and is cost effective compared to standard care. <h3>Methods</h3> FARSTER-care is a multi-centre, two arm, parallel group, open RCT, including an internal pilot study and embedded health economic analysis. The trial aims to recruit 588 cardiac surgery participants who have had a sternotomy at UK centres over 24 months and randomising participants 1:1 to the FARSTER-care (intervention) or standard care (control) arms. Participants in the intervention arm will have specialist outpatient review at three weeks after hospital discharge, followed by commencement of CR from four weeks. Standard care includes specialist outpatient review at six weeks after hospital discharge, followed by commencement of CR from eight weeks. Our primary outcome is the difference in ISWT (Incremental Shuttle Walk Test, meters walked) between the treatment groups at six months post-randomisation. <h3>Results</h3> No results available currently as the trial is in site set-up &amp; participant recruitment phase.