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Patient acceptance of prehabilitation for major surgery: an exploratory survey

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Abstract

Purpose

Prehabilitation programs are effective in optimising patient’s functional reserve prior to surgery and increasingly associated with reduced postoperative complications. However, acceptability of programs among patients is largely unknown. This study set out to explore the acceptability of prehabilitation from the perspective of patients awaiting major cancer surgery.

Methods

Adult patients awaiting major gastrointestinal and urological cancer surgeries were surveyed. Patients were excluded if they were unable to complete the survey due to language, intellectual impairment and/or visual/hearing deficit. The survey was designed to explore categories related to patient demographics, level of physical activity and perceived enablers and barriers to prehabilitation.

Results

One hundred and three participants presenting to a pre-anaesthesia clinic completed the survey over a 5-month period, with 83% response rate. Approximately, half of the respondents were female (55%) and were currently physically active (53%). Fewer than one third (30%) felt they completed ‘enough exercise’. The majority of participants (83%) were unfamiliar with the concept of prehabilitation but two thirds (68%) were interested in such a program after explanation. The majority of participants (72%) indicated a strong preference to exercise in a home-based environment. Medical recommendation increased willingness to participate (p < 0.001), while program costs (p = 0.01) were potential barriers to participation.

Conclusion

Patients are willing to participate in prehabilitation prior to major cancer surgery but practical barriers and facilitators should be considered when designing prehabilitation programs to maximise patient commitment to facilitate improved postoperative outcomes.

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Acknowledgements

We would like to thank Amelia Hyatt and Allison Drosdowsky, the staff of the Pre-Anaesthetic Clinic and the patients of the Peter MacCallum Cancer Centre.

Funding

Jamie Waterland is supported in her research by a National Health and Medical Research Council (NHMRC) PhD Scholarship. The NHMRC was not involved in any decisions regarding this research.

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Authors and Affiliations

  1. Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia

    Jamie L. Waterland, Hilmy Ismail, Babak Amin & Bernhard Riedel

  2. Department of Physiotherapy, The University of Melbourne, Melbourne, Australia

    Jamie L. Waterland, Catherine L. Granger & Linda Denehy

  3. Division of Allied Health, Peter MacCallum Cancer Centre, Melbourne, Australia

    Jamie L. Waterland & Linda Denehy

  4. Centre for Integrated Critical Care, The University of Melbourne, Melbourne, Australia

    Hilmy Ismail & Bernhard Riedel

  5. Physiotherapy Department, The Royal Melbourne Hospital, Melbourne, Australia

    Catherine L. Granger

Authors
  1. Jamie L. Waterland
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  2. Hilmy Ismail
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  3. Babak Amin
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  4. Catherine L. Granger
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  5. Linda Denehy
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  6. Bernhard Riedel
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Contributions

All authors contributed to the study conception and design. Material preparation was performed by Jamie Waterland, Hilmy Ismail, Babak Amin and Bernhard Riedel. Data collection, analysis and first draft preparation were performed by Jamie Waterland. Supervision was provided by Catherine Granger, Linda Denehy and Bernhard Riedel. All authors provided critical review of previous versions of the manuscript. All listed authors have seen and approved the final version of the manuscript.

Corresponding author

Correspondence to Jamie L. Waterland.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Ethics approval was gained from the Peter MacCallum Cancer Centre ethics committee (LNR/16/PMCC/142) prior to commencing recruitment.

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Waterland, J.L., Ismail, H., Amin, B. et al. Patient acceptance of prehabilitation for major surgery: an exploratory survey. Support Care Cancer 29, 779–785 (2021). https://doi.org/10.1007/s00520-020-05547-1

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  • DOI: https://doi.org/10.1007/s00520-020-05547-1

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