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. 2025 Feb 13:11:20552076251317760.
doi: 10.1177/20552076251317760. eCollection 2025 Jan-Dec.

Development and implementation of a home-based prehabilitation app for older patients undergoing elective colorectal cancer surgery. A Prospective Cohort Study

Thomas Gc Timmers  1 , Lennaert Cb Groen  2 , Hermien Schreurs  2 , Emma Rj Bruns  2
Affiliations

Development and implementation of a home-based prehabilitation app for older patients undergoing elective colorectal cancer surgery. A Prospective Cohort Study

Thomas Gc Timmers et al. Digit Health. .

Abstract

Background: Prehabilitation optimizes colorectal cancer patients' health during the preoperative waiting period, by increasing functional capacity, reducing postoperative complications, and speeding recovery. However, challenges in implementation include patients' willingness to attend multiple hospital visits, and hospitals needing trained personnel, facilities, and financial resources. An app-based prehabilitation program could address these issues by allowing patients to participate from home with remote support from healthcare professionals.

Objective: To develop and evaluate the feasibility of a digital application to offer multimodal home-based prehabilitation for older patients undergoing surgery for colorectal cancer.

Materials and methods: This single-center prospective cohort study at Northwest Clinics (Alkmaar and Den Helder, The Netherlands) included patients scheduled for elective surgery for the curative treatment of colorectal cancer. The Patient Journey App was used to deliver prehabilitation. The primary outcome was the number of patients who downloaded and activated the app. Secondary outcomes included usage information, videos viewed, questionnaires answered, and signals triggered.

Results: Ninety-seven patients were included in the study (age 72.1 [SD 0.8], 62.9% male). All patients used the app daily for a median of 29 days (IQR 23-28). Exercise videos were viewed most. Ninety-five patients activated daily exercise and protein shake reminders. Patients provided 1367 answers, triggering 79 signals related to smoking cessation, nutrition, and exercise. Response rates to in-app questionnaires were high, up to 90.5%.

Conclusions: Home-based prehabilitation via an app for older colorectal cancer surgery patients is feasible. Given the effectiveness of prehabilitation programs, the scarcity of healthcare professionals, and patients' reluctance for frequent in-person visits, home-based prehabilitation programs via an app could become a valuable added modality for offering these programs.

Trial registration: 2020.0600 (VU University Medical Center).

Keywords: Colorectal cancer; app; digital care; prehabilitation; surgery.

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Conflict of interest statement

The principal investigator, Thomas Timmers, is one of the cofounders of Interactive Studios. Interactive Studios is the company that developed the app used in this study. Interactive Studios offered the app used in this study free of charge. The coauthors declare that the research was conducted in the absence of any other commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1.
Figure 1.
An overview of the elements of home-based prehabilitation.
Figure 2.
Figure 2.
Examples of the interactive app used as an intervention, translated from Dutch (language used in the study) to English. From left to right: video with general information on prehabilitation, setting daily reminders for protein shakes, video with bodyweight exercises, personal progress tracker.
Figure 3.
Figure 3.
Patient flow diagram.
See this image and copyright information in PMC

References

    1. Ekdahl AW, Andersson L, Friedrichsen M. “They do what they think is the best for me.” Frail elderly patients’ preferences for participation in their care during hospitalization. Patient Educ Couns 2010; 80: 233–240. - PubMed
    1. Rooijen VJS, Molenaar JLC, Schep G, et al. Making patients fit for surgery. Am J Phys Med Rehabil 2019; 98: 888–896. - PubMed
    1. Velde DVM, Leeden DVM, Geleijn E, et al. What moves patients to participate in prehabilitation before major surgery? A mixed methods systematic review. Int J Behav Nutri Phys Activity 2023; 20. DOI: 10.1186/s12966-023-01474-6 - DOI - PMC - PubMed
    1. Klerk DM, Dalen VDH, Venrooij N-VLMW, et al. A multimodal prehabilitation program in high-risk patients undergoing elective resection for colorectal cancer: a retrospective cohort study. Eur J Surg Oncol 2021; 47: 2849–2856. - PubMed
    1. Driessens H, Wijma GA, Buis IC, et al. Prehabilitation: tertiary prevention matters. Br J Surg 2024; 111. DOI: 10.1093/bjs/znae028 - DOI - PMC - PubMed

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