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. 2025 Jun 19;33(7):597.
doi: 10.1007/s00520-025-09641-0.

Promising patient experiences with a smartphone app and remote coaching for improving physical activity and protein intake to enhance recovery after oncological surgery: a multi-methods study

C van Westerhuis #  1   2 , M E de Leeuwerk #  3   4 , E W J van der Werf  3 , H M Kruizenga  5   4   6 , V de Groot  3 , E Geleijn  3 , M van der Leeden  3   4 , M van der Schaaf  4   7   8
Affiliations

Promising patient experiences with a smartphone app and remote coaching for improving physical activity and protein intake to enhance recovery after oncological surgery: a multi-methods study

C van Westerhuis et al. Support Care Cancer. .

Abstract

Purpose: The Optimal Physical Recovery After Hospitalization (OPRAH) Intervention is a blended intervention, combining a smartphone app for self-monitoring of physical activity and protein intake with coaching from a physiotherapist and dietician, to enhance the functional recovery after gastro-intestinal or lung cancer surgery. The aim was to evaluate patients' experiences with the OPRAH intervention.

Methods: This study used a multi-method approach, incorporating semi-structured interviews and an online questionnaire. The questionnaire included the System Usability Scale (SUS) to evaluate the smartphone app. Sixty-eight patients were invited to complete the online survey, 58 providing responses. Purposeful sampling guided the selection of participants for interviews (n = 24), which focused on experiences with the application, activity tracker, and remote coaching. The interview data were analyzed qualitatively using an inductive thematic approach.

Results: The app was rated with an excellent usability (mean ± SD SUS of 86.2 ± 12.0) and 97% of the patients would recommend the intervention to others. Patients reported that the intervention enhanced their understanding of their recovery process, motivated them to achieve protein and physical activity goals, and contributed to their overall recovery. The combination of app usage and monitoring by a physiotherapist and dietician fostered a sense of being supported. However, patients suggested that the intervention could be improved by further tailoring it to individual needs, detailing the nutritional component of the app, and redesigning the activity tracker bracelet.

Conclusions: The OPRAH intervention demonstrated excellent system usability and predominantly positive experiences. Incorporating patient recommendations could further support its integration into regular healthcare.

Keywords: Cancer; Supportive Care; Surgery; Telerehabilitation.

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Conflict of interest statement

Declarations. Ethical approval: The trial protocol has been approved by the Medical Ethical Research Committee (METC) of Amsterdam UMC, location VUmc (METC 2021.0627). This study will be conducted according to the principles of the Declaration of Helsinki (version October 2013), in accordance with the Dutch Medical Research Involving Human Subjects Act (WMO) and the Dutch Personal Data Protection Act (General Data Protection Regulation (GDPR)). The trial has been registered at the International Clinical Trials Registry Platform (NL9793) and the study description is available at the following web link: https://trialsearch.who.int/Trial2.aspx?TrialID=NL9793 . All amendments of the protocol will be notified to the METC and the competent authority. Non-substantial amendments will not be notified to the accredited METC and the competent authority but will be recorded and filed by the sponsor. Participating sites in the study will be notified of any changes to the study protocols. This will enable them to make the necessary arrangements to incorporate the changes, if necessary, and to confirm their continued support for the study after the implementation of the changes. All patients will sign informed consent prior to participation in the trial. All participants will be informed that they are under no obligation to enter the trial and that they can withdraw at any time during the trial without having to give a reason and that this will not affect the medical care they receive. Consent to participate: This study was part of the OPRAH trial, which has been approved by the Medical Ethical Research Committee (METC) of Amsterdam UMC, location VUmc (METC 2021.0627). This trial was conducted according to the principles of the Declaration of Helsinki (version 9, October 2013), in accordance with the Dutch Medical Research Involving Human Subjects Act (WMO) and the Dutch Personal Data Protection Act (General Data Protection Regulation (GDPR)). The trial has been registered at the International Clinical Trials Registry Platform (NL9793) and the study description is available at the following web link: https://trialsearch.who.int/Trial2.aspx?TrialID=NL9793 . All patients signed informed consent prior to participation in the trial and additionally before interviews. All participants were informed that they are under no obligation to enter the trial and that they can withdraw at any time during the trial without having to give a reason and that this will not affect the medical care they receive. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Screenshots of the English language version on the Atris app
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