Authors
Julie R. Piazza, Office of Patient Experience, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Alexander A. Brescia, Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI AND Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MIFollow
Jessica N. Jenkins, Department of Child and Family Life, C.S. Mott Children’s Hospital, Michigan Medicine, Ann Arbor, MI AND Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Alexander J. Ivacko, Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Xiaoting Wu, Office of Patient Experience, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Sara M. Jafri, Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MIFollow
Christopher J. Varlamos, Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MIFollow
James C. Piazza, Office of Patient Experience, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Lindsay K. Heering, Department of Child and Family Life, C.S. Mott Children’s Hospital, Michigan Medicine, Ann Arbor, MIFollow
Stefanie L. Peters, Frankel Cardiovascular Center, Michigan Medicine, Ann Arbor, MIFollow
Molly Dwyer-White, Caswell Diabetes Center and Brehm Center, University of Michigan, Ann Arbor, MIFollow
Bailey H. Brown, Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Faraz N. Longi, Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Katelyn P. Monaghan, Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Frederick W. Bauer, Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Varun G. Kathawate, Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Melissa C. Webster, Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Amanda M. Kasperek, Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Nickole L. Garvey, Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Claudia Schwenzer, Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MIFollow
Kiran H. Lagisetty, Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Michelle Riba, Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Donald S. Likosky, Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI AND Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MIFollow
Jennifer F. Waljee, Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI AND Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Nicholas H. Osborne, Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI AND Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
Mary E. Byrnes, Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI AND Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MIFollow
G. Michael Deeb, Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI AND Frankel Cardiovascular Center, Michigan Medicine, Ann Arbor, MIFollow
Abstract
Non-pharmacological techniques designed to reduce anxiety, pain, and healthcare utilization have shown effectiveness in pediatric and non-surgical adult populations; however, their application has not been widely evaluated among adult surgical patients. This study randomized opioid-naive adults undergoing first-time, elective cardiac surgery to receive either targeted interventions from a trained “comfort coach” or usual care. The primary outcome assessed was healthcare utilization, specifically measured as the number of days at home within the first 30 days post-surgery. Secondary outcomes included postoperative opioid use and patient-reported outcomes, collected via validated surveys. Additionally, 50 participants in the intervention group completed semi-structured qualitative interviews to explore their experience and acceptability of the intervention. Among the 160 randomized subjects (COACH: n = 77; USUAL CARE: n = 79), three did not undergo surgery and one was excluded for dementia, leaving 156 participants with a mean age of 63 years, 33% of whom were female. The primary outcome was not statistically different between groups, with the COACH group averaging 22.8 ± 4.4 days at home and the USUAL CARE group 22.0 ± 4.5 days (p = 0.26). Both groups exhibited similar decreases in anxiety and depression from preoperative clinic to 90-days postoperatively, and discharge pain scores averaged below 3/10. Notably, opioid prescriptions were larger than patient-reported consumption (p < 0.001). Qualitative analysis revealed the comfort coach intervention was highly valued, with participants identifying positive themes regarding the role and impact of the coach. These findings suggest that a comfort coach is a valued, novel healthcare role for cardiac surgery patients, and further research should prioritize comprehensive patient-reported outcomes.
Recommended Citation
Piazza J,
Brescia A,
Jenkins J,
Ivacko A,
Wu X,
Jafri S,
Varlamos C,
Piazza J,
Heering L,
Peters S,
Dwyer-White M,
Brown B,
Longi F,
Monaghan K,
Bauer F,
Kathawate V,
Webster M,
Kasperek A,
Garvey N,
Schwenzer C,
Lagisetty K,
Riba M,
Likosky D,
Waljee J,
Osborne N,
Byrnes M,
Deeb G.
Impact of Non-Pharmacological Interventions on Patient Experience, Opioid Use, and Healthcare Utilization in Adult Cardiac Surgery: A Randomized Controlled Mixed Methods Trial.
Patient Experience Journal.
2025;
12(3):61-74.
doi: 10.35680/2372-0247.2047.
