Virtual Prehabilitation in Patients With Cancer Undergoing Surgery During the COVID-19 Pandemic: Protocol for a Prospective Feasibility Study

Genevieve Lambert, Kenneth Drummond, Bhagya Tahasildar, Francesco Carli, Genevieve Lambert, Kenneth Drummond, Bhagya Tahasildar, Francesco Carli

Abstract

Background: Since the beginning of the COVID-19 pandemic, preoperative care, also termed prehabilitation, has become increasingly relevant due to the decreasing functional and psychosocial health of patients with cancer, which is a result of the pandemic restrictions. Concurrently, access to telehealth has improved; telehealth comprises all remote care delivery facilitated by information technologies (ie, virtually).

Objective: The aim of this protocol is to describe the rationale and methodology for a major trial investigating the feasibility and safety of multimodal virtual prehabilitation services (ie, teleprehabilitation).

Methods: This single-arm feasibility trial aims to recruit 100 patients with cancer to receive teleprehabilitation throughout their preoperative period. The inclusion criteria are as follows: (1) 18 years of age or older, (2) scheduled for elective cancer surgery and referred by a surgeon, (3) medically cleared by the referring physician to engage in physical activity, and (4) have a good comprehension of the English or French language. Feasibility will be assessed by documenting recruitment, adherence, and retention rates, in addition to patients' motives for not participating in the trial, low participation, or discontinuation. The secondary outcome of safety will be assessed by reporting program-related adverse events.

Results: The Montreal General Hospital Foundation funded the project in August 2020. The protocol was then approved by the Research Ethics Board of the McGill University Health Centre in January 2021 (ID No. 2021-6730). The first patient was recruited in March 2021, and recruitment is expected to end in September 2022. As of March 2022, 36 patients have been recruited, including 24 who have completed their participation. No adverse events have been reported. Data collection is expected to conclude in November 2022. Data analysis will be performed, and the results will be published by the beginning of 2023.

Conclusions: This trial will provide guidance on the use of telehealth in the administration of prehabilitation services. The trial will provide a large amount of information that will respond to gaps in the literature, as there are minimal reports on the use of telehealth rehabilitation and prehabilitation services among elderly populations and in acute contexts, such as the preoperative period.

Trial registration: ClinicalTrials.gov NCT0479956; https://ichgcp.net/clinical-trials-registry/NCT04799561.

International registered report identifier (irrid): DERR1-10.2196/29936.

Keywords: cancer care; exercise; functional capacity; malnutrition; prehabilitation; psychosocial support; telehealth.

Conflict of interest statement

Conflicts of Interest: None declared.

©Genevieve Lambert, Kenneth Drummond, Bhagya Tahasildar, Francesco Carli. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 06.05.2022.

Figures

Figure 1
Figure 1
Patient-centered delivery-of-care model.
Figure 2
Figure 2
The technological tools of the telehealth system.

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