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Prehabilitation Before Gastrointestinal Cancer Surgery: Protocol for an Implementation Study.

Kristy-Lee Raso1,2, Michael Suen2,3, Jane Turner4

  • 1Department of Nutrition and Dietetics, Concord Repatriation General Hospital, Concord, Australia.

JMIR Research Protocols
|March 27, 2023
PubMed
Summary

This study implemented a multimodal prehabilitation program for gastrointestinal cancer patients undergoing surgery. The program, combining exercise, nutrition, and nursing support, showed promise for improving patient outcomes and integrating into standard care.

Keywords:
cancercolorectalexercisegastrointestinalnutritionprehabilitationpsychologicalsurgerytelehealth

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Area of Science:

  • Oncology
  • Surgical Care
  • Implementation Science

Background:

  • Colorectal and upper gastrointestinal cancers are treated with surgery.
  • Poor preoperative status negatively impacts surgical outcomes.
  • Prehabilitation aims to enhance patient reserves before surgery.

Purpose of the Study:

  • To implement a multimodal prehabilitation program into standard care for gastrointestinal cancer patients.
  • To assess the program's impact on functional capacity, nutritional status, psychological well-being, and surgical outcomes.

Main Methods:

  • An implementation study using a pre-post design.
  • Inclusion of patients with gastrointestinal cancer scheduled for curative surgery.
  • Evaluation using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.

Main Results:

  • Protocol approved in December 2019; recruitment spanned January 2020 to December 2021.
  • Recruitment adapted for COVID-19 with remote/telehealth options.
  • 77 participants recruited over 16 months.

Conclusions:

  • Prehabilitation offers a strategy to optimize functional capacity and surgical results.
  • This study informs the integration of prehabilitation into routine healthcare.
  • Adaptive delivery models, including telehealth, are key for successful implementation.