Preparing for colorectal surgery: a feasibility study of a novel web‐based multimodal prehabilitation programme in Western Canada

Abstract

AimPrehabilitation for colorectal cancer has focused on exercise‐based interventions that are typically designed by clinicians; however, no research has yet been patient‐oriented. The aim of this feasibility study was to test a web‐based multimodal prehabilitation intervention (known as PREP prehab) consisting of four components (physical activity, diet, smoking cessation, psychological support) co‐designed with five patient partners.MethodA longitudinal, two‐armed (website without or with coaching support) feasibility study of 33 patients scheduled for colorectal surgery 2 weeks or more from consent (January–September 2021) in the province of British Columbia, Canada. Descriptive statistics analysed a health‐related quality of life questionnaire (EQ5D‐5L) at baseline (n = 25) and 3 months postsurgery (n = 21), and a follow‐up patient satisfaction survey to determine the acceptability, practicality, demand for and potential efficacy in improving overall health.ResultsPatients had a mean age of 52 years (SD 14 years), 52% were female and they had a mean body mass index of 25 kg m−2 (SD 3.8 kg m−2). Only six patients received a Subjective Global Assessment for being at risk for malnutrition, with three classified as ‘severely/moderately’ malnourished. The majority (86%) of patients intended to use the prehabilitation website, and nearly three‐quarters (71%) visited the website while waiting for surgery. The majority (76%) reported that information, tools and resources provided appropriate support, and 76% indicated they would recommend the PREP prehab programme. About three‐quarters (76%) reported setting goals for lifestyle modification: 86% set healthy eating goals, 81% aimed to stay active and 57% sought to reduce stress once a week or more. No patients contacted the team to obtain health coaching, despite broad interest (71%) in receiving active support and 14% reporting they received ‘active support’.ConclusionThis web‐based multimodal prehabilitation programme was acceptable, practical and well‐received by all colorectal surgery patients who viewed the patient‐oriented multimodal website. The feasibility of providing active health coaching support requires further investigation.