Mental health preparation before major surgery could improve recovery for older patients, according to a new study published in JAMA Network Open.
Researchers found that addressing anxiety, depression and medication use before surgery led to greater improvements in mental health three months after an operation than providing patients with educational materials alone.
“The stress of surgery can worsen anxiety and depression symptoms and affect patients’ recovery and overall health,” said Joanna Abraham, the study’s first author.
The researchers argue that preparation for major surgery should address both physical and psychological health. They said mental health support from trained professionals is often absent from standard care provided before and around surgery.
“We recognize the importance of getting the body into shape before surgery, but preparing the mind and the brain is just as important,” said senior author Eric J. Lenze.
The study involved 306 adults aged 60 and older who were scheduled to undergo cardiac, cancer-related or orthopaedic surgery. Participants were divided into two groups to assess whether additional mental health and medication support could improve outcomes.
One group received self-help educational materials that they could review independently. The other group took part in between eight and 12 telephone sessions with trained mental health professionals, including social workers and mental health counsellors.
Patients in the second group also received personalised medication reviews from pharmacists and doctors. The reviews focused on safely adjusting or reducing the use of high-risk medicines where appropriate.
Three months after surgery, patients who received the additional support experienced a reduction in depression and anxiety symptoms that was 2.2 to 2.5 points greater than the control group on a 48-point scale.
The strongest improvement was recorded among older adults undergoing cancer surgery. Their scores were nearly five points lower than those of patients who received educational materials alone.
Participants also reported positive experiences with the programme. Researchers said patients and healthcare providers found the additional support manageable and straightforward to fit into existing surgical care.
Michael S. Avidan, one of the study’s authors, said healthcare should take a broader approach by bringing anesthesiology and psychiatry together to treat patients as a whole.
Abraham said the findings suggest proactive mental health support does not necessarily require major changes to hospital systems.
“What makes this care model so promising is that it’s practical to deliver,” she said. “Patients and healthcare providers found the program manageable and easy to integrate into existing surgical workflows.”
The researchers said the findings support greater attention to psychological wellbeing as part of preparation for major operations, particularly among older adults facing complex procedures.
