ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1660083
This article is part of the Research TopicAdvancing Benign Surgery: Techniques, Outcomes, and Educational InnovationsView all 12 articles
Adherence to the Enhanced Recovery After Surgery protocol and its influencing factors among patients in Southwestern China: A multicentre cross-sectional study
Provisionally accepted
- 1First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- 2The Chinese University of Hong Kong, Hong Kong, Hong Kong, SAR China
- 3Chongqing Liangping District People's Hospital, Chongqing, China
- 4Chongqing University Cancer Hospital, Chongqing, China
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Background There is limited research on adherence to Enhanced Recovery After Surgery (ERAS) protocols among hospitalized patients and the factors influencing it, both in China and globally. Methods A random sample of 1,203 participants from 45 hospitals in Southwestern China was surveyed on ERAS protocol implementation, including 16 items. A questionnaire assessed awareness, attitudes, and social and environmental support factors. Multivariable linear regression model was used to analyze factors affecting ERAS adherence. Results The final analysis included 806 surgical patients, with an average ERAS adherence rate of 68.8% (56.3%, 81.3%). The highest completion rates were seen in avoidance of prolonged fasting (88.6%) and prophylactic antibiotic use (88.2%), while the lowest were in preoperative oral carbohydrate intake (42.2%) and deep vein thrombosis prevention (52.4%). Factors positively influencing adherence included educational background (P = 0.010), surgical grade (P = 0.013), positive attitudes towards ERAS (P < 0.001), perception of ERAS (P < 0.001) and social and environmental supports (P < 0.001). Negative influences included non-tertiary center status (P = 0.039) and negative attitudes (P = 0.002). Conclusion ERAS adherence in Southwestern China remains low, with various factors such as hospital grade, patients' educational background, their perceptions and attitudes towards ERAS, and their social and environmental support influencing ERAS adherence rates.
Keywords: adherence, Inpatients, Eras, Southwestern China, Influencing factors
Received: 05 Jul 2025; Accepted: 03 Oct 2025.
Copyright: © 2025 Mu, Chen, Ren, Lv, Hu, Liu, Wang, Ran and Shen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yiwei Shen, yiwei@hospital.cqmu.edu.cn
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