Patients' and carers' views on research priorities in prehabilitation for cancer surgery

Abstract

Introduction: The views of patients and carers are important for the development of research priorities. This study aimed to determine and compare the top research priorities of cancer patients and carers with those of multidisciplinary clinicians with expertise in prehabilitation.

Materials and methods: This cross-sectional study surveyed patients recovering from cancer surgery at a major tertiary hospital in Sydney, Australia, and/or their carers between March and July 2023. Consenting patients and carers were provided a list of research priorities according to clinicians with expertise in prehabilitation, as determined in a recent International Delphi study. Participants were asked to rate the importance of each research priority using a 5-item Likert scale (ranging from 1 = very high research priority to 5 = very low research priority).

Results: A total of 101 patients and 50 carers participated in this study. Four areas were identified as research priorities, achieving consensus of highest importance (> 70% rated as "high" or "very high" priority) by patients, carers, and clinical experts. These were "optimal composition of prehabilitation programs" (77% vs. 82% vs. 88%), "effect of prehabilitation on surgical outcomes" (85% vs. 90% vs. 95%), "effect of prehabilitation on functional outcomes" (83% vs. 86% vs. 79%), and "effect of prehabilitation on patient reported outcomes" (78% vs. 84% vs. 79%). Priorities that did not reach consensus of high importance by patients despite reaching consensus of highest importance by experts included "identifying populations most likely to benefit from prehabilitation" (70% vs. 76% vs. 90%) and "defining prehabilitation core outcome measures" (66% vs. 74% vs. 87%). "Prehabilitation during neoadjuvant therapies" reached consensus of high importance by patients but not by experts or carers (81% vs. 68% vs. 69%).

Conclusion: This study delineated the primary prehabilitation research priorities as determined by patients and carers, against those previously identified by clinicians with expertise in prehabilitation. It is recommended that subsequent high-quality research and resource allocation be directed towards these highlighted areas of importance.

Keywords: Cancer; Outcomes; Prehabilitation; Preoperative; Research priorities; Surgery.

Fig. 1

Prehabilitation research priorities according to experts’, patients’, and carers’ views. Data presented as percentage. Research priorities listed in descending order from highest priority to lowest priority according to patient consensus. Research priority rating scale: 1 = very high priority, 2 = high priority, 3 = moderate priority, 4 = low priority, or 5 = very low priority. High research priority determined by the number of experts, patients, and carers that rated 1 (very high priority) or 2 (high priority) in the research priority rating scale. Research priority reached consensus of high importance by a group if rated as 1 (very high) or 2 (high) by > 70% of participants in the group. Color scale: red (less than 55% of participants in group rated 1 (very high priority) or 2 (high priority) in the research priority rating scale) to dark green (more than 95% of participants in group rated 1 (very high priority) or 2 (high priority) in the research priority rating scale), with yellow at midpoint (75% of participants in group rated 1 (very high priority) or 2 (high priority) in the research priority rating scale). ^Research priority reached consensus of high importance by all groups. *Significant difference between ratings across expert, patient, and carer groups (p < 0.05)