Maximizing patient adherence to prehabilitation: what do the patients say?

Abstract

These findings highlight the need to make prehabilitation programs more patient-centered. This is critical when designing more effective therapeutic strategies tailored to meet patients' specific needs while overcoming program non-adherence.

Multi‐modal prehabilitation: addressing the why, when, what, how, who and where next?

“…Given that prehabilitation occurs at a very stressful point in time for the cancer patient, it must be emphasised that the patient's own goals, needs and preferences must be reflected in their programme prescription. Barriers should be identified and strategically addressed in order to maximise adherence . As mentioned previously, the time frame for prehabilitation is relatively short, so patient compliance is critical and any approach must take into consideration factors that will favour active participation.…”

Study protocol of a single-arm pre-post study to assess the preliminary effectiveness and feasibility of a home-based bimodal prehabilitation program on preoperative aerobic fitness in high-risk patients scheduled for liver or pancreatic resection

“…12 Recently however, it was found that the most reported barrier to participate in a prehabilitation program was related to transportation (e.g., paying for parking, arranging transportation), besides finding the time. 14 An important next step is therefore to improve the participation rate and adherence of high-risk patients with respect to prehabilitation programs in order to ensure the most vulnerable patients are empowered to engage. Indeed, high-risk patients, who are often older and frailer, are less likely to participate in a hospital-based training program, than in a home-based training program.…”

“…Indeed, high-risk patients, who are often older and frailer, are less likely to participate in a hospital-based training program, than in a home-based training program. 11,14 Though, there are only a few studies available that investigated the effects of home-based prehabilitation. 9 Nakajima et al recently reported that an unsupervised home-based exercise prehabilitation program improved physical fitness (median 6-minute walk test distance improved from 530 to 554 m; p<0.001) before hepatopancreatobiliary surgery in the intervention group, with merely a statistically significant reduction in postoperative length of stay compared to the control group.…”

“…[8][9][10][11][12] Most preoperative training programs were carried out under supervision in an outpatient clinic; however, a personalized exercise program in a home-based setting might enhance the participation rate, motivation, and adherence of (high-risk) patients, and has proven to be the preferred method for a prehabilitation program. 11,13,14 Although several studies investigated the effects of exercise prehabilitation in liver and/or pancreatic resection and reported positive effects on physical fitness and postoperative morbidity, there is limited evidence addressing the feasibility and effectiveness of supervised home-based prehabilitation in these populations. 9,12,15,16 Additionally, optimal nutrition during exercise is required, knowing the profound effects on the muscle protein turnover during exercise.…”

Preoperative optimization of physical functioning in patients with colorectal cancer

“…Prehabilitation should really be seen and executed as a team effort. The program itself must be supervised, executed in the right context and should focus on personal risk factors, goals, needs, and preferences to achieve maximal results and maximal therapy adherence [68]. Furthermore, it is important to monitor progression of physical fitness and functional abilities during the preoperative optimization period using performance-based tests in a rather high frequency fashion to assess training progression -and prevent the patient form therapy failure -and to guide physical therapy treatment [3,69].…”