In Reply We have carefully read the comments of Rozental et al regarding our published article.1 The authors suggest that the implementation of Enhanced Recovery After Surgery (ERAS) protocols not only decreases morbidity rate and hospital stay2 but, when used worldwide, it should reduce disparities in health care. We could not agree more. In this context, the relevant question has moved from documenting the effectiveness of the Enhanced Recovery Pathways (ERP) to detect which items are significantly associated with both better outcomes and adherence to the protocol. Our study showed that the adherence to ERAS protocols in colorectal surgery is low, and there are many centers that wrongly believe they are doing well with the compliance.1 Regarding disparities in health care, Europe could be in some way different to the United States, but a study conducted in Scandinavia3 has found that although their centers have a greater adherence to the protocol than the Spanish ones, there is a great disparity within compliance between hospitals.3
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Ripollés-Melchor J, Ramírez-Rodríguez JM, Aldecoa C. Role of Adherence to Enhanced Recovery After Surgery Programs in Mitigating Healthcare Disparities—Reply. JAMA Surg. 2020;155(1):92. doi:10.1001/jamasurg.2019.3498
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: