[Position paper on prehabilitation in Germany].

Area of Science:

• Perioperative Medicine
• Geriatric Care
• Oncology Support

Background:

• Prehabilitation is increasingly vital in patient-centered perioperative care.
• It involves targeted preoperative interventions to improve patient outcomes.

Purpose of the Study:

• To assess the current status of prehabilitation nationally and internationally.
• To identify barriers to prehabilitation implementation.
• To offer practical recommendations for clinical use.

Main Methods:

• Position paper synthesizing current evidence and expert opinion.
• Analysis of implementation barriers and facilitators.
• Development of recommendations for clinical practice.

Main Results:

• Prehabilitation, including exercise, nutrition, and psychological support, reduces complications and improves recovery, particularly in older, multimorbid, and oncology patients.
• Implementation in Germany is slow due to reimbursement and resource limitations.
• A stepwise, tailored introduction for high-risk groups is recommended.

Conclusions:

• Prehabilitation should be integrated into enhanced recovery after surgery (ERAS) and rehabilitation pathways.
• National networking, standardized protocols, digital tools, and political support are crucial for sustainable integration.
• Addressing structural and financial barriers is essential for widespread adoption.