Effects of a WhatsApp-assisted Prehabilitation for Patient Undergoing Elective Colorectal Cancer Surgery

January 29, 2026 updated by: SUNG HOI LING SHERING, Tseung Kwan O Hospital, Hong Kong

WhatsApp-assisted Prehabilitation Programme for Adult Patient Undergoing Elective Colorectal Cancer Surgery - A Randomised Controlled Trial

The goals of this study is to evaluate the feasibility and the effects of a WhatsApp-assisted prehabilitation for colorectal cancer patients undergoing elective surgery. The main questions are: If the digital prehabilitation is feasible and acceptable by the colorectal cancer patient prior to elective surgery? If this prehabilitation helps to improve the postoperative complications, length of stay, physical activity and psychological well-being for colorectal cancer patients receiving surgery.

Researcher will compare the prehabilitation plus standard care to standard care only to see if the prehabiliation helps the colorectal cancer patients.

Participants will: 1) enrolled in a approximate 4 weeks (3 episodes/ week) prehabilitation program containing educational information of colorectal cancer, dietary advice, exercises training and psychological podcasting. 2) will answer the survey weekly and after surgery. 3) keep the standard care as per department guidelines

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Colorectal cancer ranks the second most prevalent forms of cancer in Hong Kong and surgery is still the primary curative option. Although compromising result of shorten general length of stay (LOS) in enhanced recovery after surgery (ERAS) protocol is illustrated, surgical complications such as postoperative ileus (POI) remain unresolved and significant burden associated leads to suboptimal patients' outcomes of prolonged LOS and physical deconditioning with extended rehabilitation. Prehabilitation refers to optimization in a single or multi-disciplinary approach of exercises training, nutritional therapy and psychological counselling, improves physical fitness, strengthens cardiopulmonary function and reduce mental distress through lifestyle modification and better physiological reserve. However, the concept of educations in form of preoperative exercises and nutritional counselling outweighs the purposes of actual prehabilitation and short-handed allied health professionals limited accessibility of regular out-patient counselling in the current clinical practices. Consequently, poor adherence to these preoperative trainings may result in to poor surgical outcomes.

A single with assessor-blinded, double-armed randomised controlled trial study with a prior pilot will be employed to examine the feasibility and effects of a technology-assisted prehabilitation for patients with colorectal cancer surgery. Outcomes of postoperative complications, LOS, physical activity, nutritional status, gastrointestinal recovery and psychological well-being will be evaluated. Elective colorectal cancer surgery patient will be invited to participated in this study.

The result will provide insights of the use of digital approach. To our knowledge, this is the very first trial of digital prehabilitation for CRC patients in Hong Kong public hospitals. Therefore, it provides positive contribution and acts as an important quality benchmark for patients' outcomes. The findings will also generate knowledge on the optimalization of care provided to CRC patients prior to surgery and assist to develop a structured and effective health system in our community. This innovation may have implications to other research studies and extends the potential clinical practices to related subspecialities such as gastric cancer.

Study Type

Interventional

Enrollment (Estimated)

100

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • diagnosis of colorectal-related cancer
  • scheduled for elective colorectal cancer surgery as primary treatment
  • aged 18 years or above
  • expected surgery date more than 21 days
  • able to collaborate in the study and sign the informed consent
  • able to use WhatsApp application

Exclusion Criteria:

  • identified or known premorbid, that inability to follow the programme
  • able to understand written and spoken Cantonese/ Chinese

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Standard care
Experimental: WhatsApp-assisted prehabilitation
Patient will receive WhatsApp-assisted prehabilitation plus standard care
Other: Standard care
Standard care as per department guidelines with ERAS protocol (including smoking cessation program, preoperative counselling, early rehabilitation program)
Other: Intervention
In addition to standard care, participants will receive digital approach of WhatsApp-assisted prehabilitation programme and then start the home-based training for about 3-4 weeks prior to the surgery. The WhatsApp-assisted prehabilitation includes exercises training, dietary advice and psychological support. Contents will contain elements of physical training (e.g. aerobic and resistance exercises) and psychological therapy (e.g. meditation) will be delivered through WhatsApp at three sessions (day 1, 3 & 5) per week for 30 minutes and 15 minutes respectively, educational information associated with colorectal cancer surgery and prehabilitation(e.g. high risks factors towards surgical complications) and dietary advices (e.g. recipes) will be delivered on weekly
Other Names:
  • Prehabilitation

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative complications
Time Frame: Postoperative period: assessed up to first year postoperative
measured by the Comprehensive Complication Index (CCI), which integrates in a single formula all complications by severity, ranging from 0 (uneventful course) to 100 (death).
Postoperative period: assessed up to first year postoperative

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Length of hospital stay (LOS)
Time Frame: Postoperative period: assessed up to the first year postoperative
to evaluate the length of postoperative hospital stay
Postoperative period: assessed up to the first year postoperative
Gastrointestinal recovery
Time Frame: Postoperative period: assessed up to 30 days postoperative
measured as time to first flatus (in hours)
Postoperative period: assessed up to 30 days postoperative
Gastrointestinal function
Time Frame: Postoperative period: assess up to 30 days postoperative
measured as time to first bowel (hours)
Postoperative period: assess up to 30 days postoperative
Anxiety and depression
Time Frame: Assessments at baseline and on the day of discharge: assess up to first year postoperative
assessed by the Chinese version of Hospital Anxiety and Depression Scale (C-HADS), a 14-question measure with seven items each for depression and anxiety. HADS generates separate scores for anxiety and depression as well as a combined score of psychological distress. Continuos variable 0-21 (0-7 normal value, 11-21 anxiety/depression), higher value from baseline will represent a worse outcome.
Assessments at baseline and on the day of discharge: assess up to first year postoperative
Quality of health-related life
Time Frame: Assessments at baseline and on the day of discharge: assess up to first year postoperative
evaluated by the Short Form 12 Health Survey (SF-12 version 2 (Hong Kong)), with Physical Component Summary (PCS) and Mental Component Summary (MCS). Scores range from 0-100 for the 8 underlying health domains, with higher scores meaning better Health-Related Quality of Life (HRQoL)
Assessments at baseline and on the day of discharge: assess up to first year postoperative
Physical activity
Time Frame: Assessments at baseline, weekly before the surgery and on the day of discharge: assess up to first year postoperative
measured by the International Physical Activity Questionnaire Short Form (IPAQ-SF), seven items were assessed in frequency and duration over the past seven days, categorizing it into four types: vigorous intensity, moderate intensity, walking, and sitting. An average metabolic equivalents score (MET, min·w-1) was calculated to assess total physical activity as well as for each type of activity, separately. For walking activities, all types of walking were included and an average MET score was derived. The same procedure was carried out for medium intensity and high intensity activities. By calculating the number of activity days multiplied by the average duration per activity, statements about the energy consumption per week and the fitness level can be derived.
Assessments at baseline, weekly before the surgery and on the day of discharge: assess up to first year postoperative

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Adherence to the prehabilitation
Time Frame: From enrollment to the completion of study up to 18 months
percentage of completed at least 75% of the prehabilitation.
From enrollment to the completion of study up to 18 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Tseung Kwan O Hospital, Hong Kong

Collaborators

Chinese University of Hong Kong

Investigators

  • Principal Investigator: SHERING SUNG, Chinese University of Hong Kong

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

January 15, 2026

Primary Completion (Estimated)

December 31, 2026

Study Completion (Estimated)

March 31, 2027

Study Registration Dates

First Submitted

January 13, 2026

First Submitted That Met QC Criteria

January 21, 2026

First Posted (Actual)

January 29, 2026

Study Record Updates

Last Update Posted (Actual)

February 3, 2026

Last Update Submitted That Met QC Criteria

January 29, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CIRB-2025-099-2

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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