Improving Compliance and Satisfaction With Quality Coffee Intake to Enhance Bowel Recovery After Colorectal Surgery: A Feasibility Study.

Background and Aim: Coffee after digestive surgery is a simple, safe, and inexpensive prevention for post-operative ileus (POI). Several meta-analyses have shown that coffee consumption in the post-operative period may enhance bowel recovery. However, uptake in clinical routine is variable, standardization challenging and compliance unknown. We hypothesized that serving tasty and freshly made quality coffee will enhance compliance and facilitate implementation of coffee following surgery. Methods: In this prospective monocentric single arm study, we proposed to every patient undergoing elective colorectal surgery 3 daily doses of freshly made and coffee with a capsule system over 3 days. Patient could choose between four different flavors with standardized caffeine level. Primary endpoints were compliance (x/total possible doses) and reasons for non-compliance. Secondary outcome was satisfaction of patients using a visual analogue scale (VAS: 0-10). Results: 50 patients were included for analysis. Median postoperative coffee consumption was 6 (IQR 5-8) during the first three post-operative days (POD), and was not modified after exclusion of patients with POI (n = 5). Median compliance was 78% (IQR 56-100) and 35 patients (70%) drank more than 2/3 of possible doses. Compliance decreased post-operatively by POD 2. The main reason for non-compliance was nausea (n = 28). Patients' satisfaction with the coffee was high (mean VAS 8.2 ± 1.6). Conclusion: This pilot study revealed high compliance and satisfaction with a standardized, personalized and freshly brewed coffee together with an enjoyable moment. Combining therapeutic interventions with enjoyable experiences may represent a promising approach to increased compliance to standardized postoperative recovery measures.