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Consumer Perspectives on the Adoption of a Prehabilitation Multimodal Online Program for Patients Undergoing Cancer Surgery.

Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, NSW 2050, Australia. Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia. Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital (RPAH), Sydney, NSW 2050, Australia. Department of Physiotherapy, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3010, Australia. Department of Health Services Research: Allied Health, Peter MacCallum Cancer Centre, Melbourne 3052, Australia. Colorectal Department, Royal Prince Alfred Hospital (RPAH), Sydney, NSW 2050, Australia. Nutrition and Dietetics Department, Royal Prince Alfred Hospital (RPAH), Sydney, NSW 2050, Australia. Neuroscience Research Australia, Sydney, NSW 2031, Australia. School of Population Health, University of New South Wales, Kensington, NSW 2052, Australia.

Cancers. 2023;(20)
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Abstract

This study aimed to explore patients' perspectives on the adoption of a prehabilitation multimodal online program. Patients recovering from gastrointestinal cancer surgery at a tertiary hospital between October 2021 and November 2022 were invited to participate. An e-Health program including intensity exercises, nutrition and psychological counselling was used. Patients were instructed to navigate the e-Health program over 24 h using an iPad and then complete the study survey. Patients' characteristics, use of technology, views and minimal expected outcomes from a preoperative online program were collected. Of the 30 patients included, most were female, most reported confidence in the use of technology, most considered the online program safe and most agreed it would be beneficial for their health. "Poor preoperative health" and "lack of motivation and encouragement" were identified as the main barriers to the uptake of a preoperative online program, while program 'simplicity' and perceived 'benefits' were the main facilitators. Significant improvement in postoperative outcomes is perceived to influence patients' willingness to participate in a preoperative multimodal e-Health program. Gastrointestinal cancer patients perceived the adoption of a preoperative multimodal e-Health application as safe to be performed at home and of potential benefit to their health. A range of patient's characteristics, barriers and facilitators to the uptake of an online program were identified. These should be considered in future preoperative multimodal online programs to enhance patient experience, adherence and efficacy. The safety and efficacy of the online prehabilitation program will need to be determined in a larger randomized controlled trial.