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

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Multimodal prehabilitation programs (exercise, nutrition, and anxiety reduction) have been shown to be successful for enhancing patients’ physical function prior to surgery, although adherence remains a challenge. Given the short pre-operative period, maintaining adherence is critical to maximize program effectiveness. This study was designed to better understand patients’ perspectives of prehabilitation and to identify factors related to program adherence.


A qualitative descriptive study was conducted based on 52 cancer patients enrolled in a prehabilitation program at the Montreal General Hospital, Montreal, Canada. Data was collected with a structured questionnaire designed to evaluate the program.


Patients enjoyed their experience in prehabilitation, especially the exercise program and training sessions. The primary motivating factor for participation was to be physically prepared for the surgery. The most challenging exercise component was resistance training, while the most enjoyed was the aerobic training. Approximately 50% of patients were interested in group fitness classes as opposed to supervised individual training sessions for reasons related to social support. The preferred methods for exercise program delivery were home-based and one supervised exercise session per week. The biggest barrier to participation was related to transportation.


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.

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The authors wish to acknowledge Mary Guay for her administrative work in the management of this study.


Funding support was provided from the Montreal General Hospital Foundation and the Peri-Operative Program (POP) Foundation, Montreal, Quebec, Canada.

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Correspondence to Celena Scheede-Bergdahl.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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The authors declare that they have no conflicts of interest.

Additional information

This work has been previously published as an abstract in Clinical Nutrition ESPEN (volume 19, pages 90–91, 2017), stemming from the 5th ERAS World Congress (May 10–12, 2017 in Lyon, France).

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Ferreira, V., Agnihotram, R.V., Bergdahl, A. et al. Maximizing patient adherence to prehabilitation: what do the patients say?. Support Care Cancer 26, 2717–2723 (2018).

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