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

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Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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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Acknowledgements

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

Funding

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

Author information

Authors and Affiliations

  1. Department of Kinesiology and Physical Education, McGill University, Currie Gymnasium, 475 Pine Avenue West, Montreal, Quebec, H2W 1S4, Canada

    Vanessa Ferreira & Celena Scheede-Bergdahl

  2. Department of Anesthesia, McGill University, Montreal General Hospital, 1650 Cedar Avenue, D10-144, Montreal, Quebec, H3G 1A4, Canada

    Vanessa Ferreira, Rashami Awasthi, Francesco Carli & Celena Scheede-Bergdahl

  3. Research Institute—McGill University Health Center, Montreal, Quebec, Canada

    Ramanakumar V. Agnihotram

  4. Department of Exercise Science, Concordia University, 7141 Sherbrooke Street West, Montreal, Canada

    Andreas Bergdahl

  5. Department of Surgery, School of Nutrition and Translational Research in Metabolism, Maxima Medical Centre and Maastricht University Medical Centre, Universiteitssingel 40, 6229 ER, Maastricht, Netherlands

    Stefanus J. van Rooijen

  6. Faculty of Education, McGill Research Centre for Physical Activity and Health, McGill University, 700 McTavish, Montreal, Quebec, H3A 1Y2, Canada

    Celena Scheede-Bergdahl

Authors
  1. Vanessa Ferreira
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  2. Ramanakumar V. Agnihotram
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  3. Andreas Bergdahl
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  4. Stefanus J. van Rooijen
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  5. Rashami Awasthi
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  6. Francesco Carli
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  7. Celena Scheede-Bergdahl
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Corresponding author

Correspondence to Celena Scheede-Bergdahl.

Ethics declarations

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.

Conflict of interest

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). https://doi.org/10.1007/s00520-018-4109-1

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  • DOI: https://doi.org/10.1007/s00520-018-4109-1

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