Feasibility and acceptance of an internet-based preoperative intervention optimizing patients’ expectations to improve outcome in heart surgery patients (the iHEART trial)

• Applicant: Professor Dr. Stefan Salzmann
• Subject Area: Personality Psychology, Clinical and Medical Psychology, Methodology ; Cardiac and Vascular Surgery
• Term: since 2022
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 499435120

PSY-HEART-I was the first trial to show that optimizing preoperative expectations via a brief psychological intervention (“EXPECT”) has a positive impact on long-term health after open-heart surgery. However, this intervention in ist face-to-face form might be beneficial only for a small subgroup of heart surgery patients, since the implementation of face-to-face psychological preparation for heart surgery faces several barriers (i.e., treatment-demand-gap, scheduling problems, time restraints, distance to the heart center, traveling despite age- and disease-dependent restrictions, COVID-19). Therefore, new approaches are necessary: Internet-based interventions may help more patients benefit from preoperative psychological preparation for heart surgery, improve patients’ outcomes after heart surgery, and reduce costs simultaneously. The proposed trial examines whether the (face-to-face) EXPECT intervention can be applied via an internet-based intervention. This trial's (the iHEART trial) primary goal is to test the feasibility and acceptability of a preoperative guided psychological internet-based intervention to optimize patients’ expectations to improve long-term outcomes after heart surgery. Since the optimal dose of guidance for internet-based interventions is still unclear, we aim to compare two online-intervention arms with different doses of therapist support (enhanced vs. Limited interaction). An internet-based intervention with comparable positive effects as the face-to-face intervention would offer tremendous scalability opportunities (more patients could be supplied with less personnel) and cost-effectiveness. This approach might dramatically improve access to the best healthcare possible for heart surgery patients and can also be a starting point to use this approach for other medical conditions. If this feasibility study’s results are promising, we will apply for a larger Germany-wide interventional trial.

• DFG Programme: Clinical Trials
• Co-Investigator: Professor Winfried Rief, Ph.D.