Original researchEnhanced Recovery After Surgery (ERAS®) multimodal programme as experienced by pancreatic surgery patients: Findings from an Italian qualitative study

- ERAS® has been recently implemented in pancreatic surgery settings, but little evidence regarding its effectiveness in improving patients' outcomes is available to date.
- Preadmission counselling should help patients to develop knowledge and to be prepared to assume an active role through the entire perioperative pathway.
- The availability of an at-home caregiver should be thoroughly assessed to guarantee support needed by patients so they may successfully complete the ERAS® programme.

BackgroundERAS® has recently been implemented in pancreatic surgery settings, but there is little evidence regarding the effects as perceived by patients. Given the lack of the knowledge in the field, the aim of this study was to capture the experience of patients undergoing pancreatic surgery who received perioperative care based on the ERAS® programme.MethodsWe designed a qualitative study undertaken in the pancreatic surgery unit of San Raffaele Hospital in Milan, Italy. Twenty-two consecutive patients were invited to participate in the study and 13 patients were interviewed. Data was collected between March and December 2012 either through face-to-face or semi-structured telephone follow-up from three to six weeks after discharge. Data was analysed using the interpretative phenomenological approach.ResultsPatients who underwent surgical pancreatic procedures and treated with ERAS® programme reported experiences based on four themes: (1) Feeling prepared to face surgery, (2) Being actively “inside” or “outside” the programme, (3) Healing at home: the best setting, and (4) “Perceiving the ordinary as extraordinary”: reaching independence, once at home.ConclusionAccording to the findings, uncomplicated pancreatic surgery patients may benefit from the ERAS® programme. Preadmission counselling should help patients to assume an active role. Once the patient returns home, the availability of a caregiver should be thoroughly assessed to guarantee the support needed by patients to successfully complete the ERAS® programme. Surgery and nursing staff should carefully monitor patients and suggest whether they continue, interrupt, or individualise the scheduled ERAS® interventions in accordance with a patient's clinical condition and preferred personal timing.