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Optimizing prehabilitation in gynecologic malignancies: Improving acceptance, overcoming barriers, and managing

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Prehabilitation programs can improve surgical recovery, but patient enrollment and retention are challenging. Adapting programs for individual needs and enhancing patient education can overcome barriers like low motivation and high intensity.

Keywords:
ExerciseGynecological oncologyNutritionPrehabilitation

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Area of Science:

  • Oncology
  • Geriatrics
  • Rehabilitation Medicine

Background:

  • Prehabilitation aims to optimize patient physical condition before surgery to enhance recovery.
  • Emerging prehabilitation programs often struggle with patient enrollment and retention, particularly among vulnerable populations.
  • The PHOCUS study identified low acceptance and retention rates in an ovarian cancer prehabilitation program.

Purpose of the Study:

  • To review and discuss obstacles and barriers to patient participation in prehabilitation programs.
  • To identify reasons for low acceptance and retention rates in the PHOCUS ovarian cancer prehabilitation study.
  • To propose strategies for improving patient enrollment and retention in prehabilitation.

Main Methods:

  • Literature review of prehabilitation participation barriers.
  • Analysis of patient enrollment and retention data from the PHOCUS study.
  • Qualitative assessment of patient-reported obstacles.

Main Results:

  • Key barriers include low patient motivation, high program intensity, and insufficient social support.
  • Vulnerable patients (elderly, frail) are less likely to participate due to program complexity.
  • The PHOCUS study experienced lower-than-expected acceptance and retention rates.

Conclusions:

  • Prehabilitation program design must address patient motivation, intensity, and social support.
  • Increasing program flexibility and tailoring interventions to individual patient needs are crucial.
  • Enhanced patient education on prehabilitation benefits can improve engagement and adherence.