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. 2023 Feb 9:5:1054894.
doi: 10.3389/fdgth.2023.1054894. eCollection 2023.

Development of a feasible and acceptable digital prehabilitation pathway to improve elective surgical outcomes

Ecushla C Linedale  1   2 , Eleanor Bills  3 , Anastasia Dimopoulos  3 , Jackie Yeoh  4   5 , Mandy Nolan  3 , Vicki Hume  3 , Sharyn Coles  1 , Jane M Andrews  2   3
Affiliations

Development of a feasible and acceptable digital prehabilitation pathway to improve elective surgical outcomes

Ecushla C Linedale et al. Front Digit Health. .

Abstract

Objectives: To codesign and assess the feasibility, acceptability, and appropriateness of a hospital-initiated, community delivered approach to health optimization (prehab) prior to planned surgery.

Design: Participatory codesign combined with a prospective, observational cohort study (April-July 2022).

Setting: A large metropolitan tertiary referral service with 2 participating hospitals.

Participants: All people referred for orthopaedic assessment for joint replacement surgery (hip or knee) triaged as category 2 or 3. Exclusions: category 1; no mobile number. Response rate 80%.

Intervention: My PreHab Program is a digitally enabled pathway that screens participants for modifiable risk factors for post-operative complications and provides tailored information to enable health optimization prior to surgery with the help of their regular doctor.

Outcome measures: Acceptability, feasibility, appropriateness, and engagement with the program.

Results: 36/45 (80%) registered for the program (ages 45-85 yrs.), completed the health-screening survey and had ≥1 modifiable risk factor. Eighteen responded to the consumer experience questionnaire: 11 had already seen or scheduled an appointment with their General Practitioner and 5 planned to. 10 had commenced prehab and, 7 planned to. Half indicated they were likely (n = 7) or very likely (n = 2) to recommend My PreHab Program to others. The My PreHab Program scored an average 3.4 (SD 0.78) for acceptability, 3.5 (SD 0.62) for appropriateness, and 3.6 (SD 0.61) for feasibility, out of a score of 5.

Conclusions: This digitally delivered intervention is acceptable, appropriate, and feasible to support a hospital-initiated, community-based prehab program.

Keywords: digital pathway; elective surgery; health service improvement; prehabilitation; surgical complications.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Perioperative timeline (adapted from ANZCA 2019) (10).
Figure 2
Figure 2
Use of the AACTT framework (14) to map the desired behavioral change objectives of the My PreHab Program.
Figure 3
Figure 3
Use of the KTA framework (15) to guide the development and implementation of the My PreHab Program.
Figure 4
Figure 4
My PreHab Pathway.
Figure 5
Figure 5
Consumer engagement with components of the My PreHab Pathway during user-testing and beta-testing in orthopaedic surgery.
Figure 6
Figure 6
Prehab areas identified and the number of people who reviewed the information on each area.
See this image and copyright information in PMC

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